Key AHCA Finance Official Doubts New HIV/AIDS Disease Management Vendor's Financial Ability

During the process of appealing the recent award of a state program to provide HIV/AIDS disease management (DM) services to Florida's Medicaid population, testimony from a key Florida Agency for Health Care Administration (AHCA) official revealed a legal and bureaucratic bombshell: The only AHCA evaluator who has reviewed the financial status of the proposed new vendor, determined that the vendor lacks the financial capacity to actually run the program, which provides crucial services to 8,000 Floridians with HIV/AIDS The AHCA official, a certified public accountant, also admitted that these concerns have not been shared with higher ups at AHCA.

"Early last month, AHCA announced that it intended to award its HIV/AIDS disease management program for the oftentimes hard-to-reach and vulnerable Medicaid population to a private, for profit vendor with little experience in HIV/AIDS," said Michael Weinstein, President of AIDS Healthcare Foundation (AHF), the nation's largest AIDS organization which has operated Positive Healthcare-Florida (PHC), the successful and cost-effective HIV/AIDS disease management program serving over 8,000 Florida Medicaid recipients for the past eight years. "In her eye-opening deposition, AHCA's financial expert testified that to significant concerns that the vendor that AHCA ultimately selected is not a financially stable company; that its financial condition was deteriorating and 'below average' and that the company lacked the financial resources to adequately perform and manage a contract of this size on behalf of Florida and the patients it serves. We will share these alarming revelations with AHCA officials immediately and ask AHCA to revisit and fully examine its process of awarding this crucial program for lifesaving HIV/AIDS services in Florida."

On Wednesday, June 20th, AHF attorneys deposed the sole AHCA financial official who reviewed the financial statements submitted by both AIDS Healthcare Foundation Disease Management and Specialty Disease Management Services, Inc. (SDM), in response to AHCA's request for proposals for its HIV/AIDS disease management program. The deponent testified that she had never communicated her concerns about SDM's lack of resources and financial instability to anyone else at AHCA because she had been specifically instructed to not communicate with anyone else about her evaluation of the proposals submitted in connection with the RFP.

"In light of this information, we are calling upon AHCA to take the only responsible course of action available to it at this point and throw out the bids and issue a new RFP," said Tom Myers AHF's General Counsel. "In contrast, if AHCA awards this contract to SDM and SDM proves incapable of performing its duties-a significant risk in light of its lack of experience managing HIV/AIDS programs in the past five years and its unstable and deteriorating financial condition-the consequences for HIV/AIDS patients in Florida will be devastating. Through an official letter to AHCA, we are putting the agency on notice of the significant concerns voiced by its very own financial evaluator."

Changes to Florida's HIV/AIDS Disease Management Program

Florida has, over the past two years, also slashed the budget for this innovative, cost-saving disease management program from $11 million down to $4.5 million annually. When Florida announced that it intended to award its HIV/AIDS disease management program to this new, financially-unstable vendor, HIV/AIDS patients, nurses, and HIV and community activists immediately engaged in a grass roots effort to stop this looming disaster, including passionate protests in Tallahassee (June 13) where some activists had the opportunity to meet and discuss the issue with Governor Charlie Crist, Miami, (June 7), Tampa (May 31), Ft Lauderdale (May 11) and spearheaded a letter-writing campaign to Florida Governor Charlie Crist to urge him to reconsider the changes to this disease management program. To date, more than 5,000 letters have been drafted.

At an appearance in St. Petersburg this past weekend, Governor Crist was again met with protesting nurses and AIDS patients and spoke publicly for the first time about the drastic cuts to Florida's AIDS programs. Many of the same nurses and AIDS patients gathered in St. Petersburg had also protested the Governor at two previous community appearances earlier in the day in Ocala and Inverness. In Ocala, as he was leaving, the Governor spoke with some of the group and told them, "I love your cause. I love what you are doing. Keep coming back." However, by the third encounter of the day with the group in St. Petersburg, the Governor reversed himself and seemed to trivialize the nurses and AIDS patients' message and goals. Referring to the protesters outside, Crist told those gathering for his official appearance, "Jeb Bush told me I wouldn't know what it's like to be governor until I had protesters. These protesters are upset that they did not get a contract ..., but that's the way it goes. It was to save you (pointing to audience) money! I'm here to tell you that AIDS patients do have care in Florida."

Regarding its own disease management program in Florida, AHF, which operates Positive Healthcare, has met or exceeded all medical performance measures for its patients, and simultaneously saved the state more than $20 million in healthcare costs over the past eight years. 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.