State dumps HIV drug program contractor

Access to medications were at risk, advocates say

The California Department of Public Health fired an out-of-state contractor Wednesday that had taken over part of a program designed to help people pay for HIV drugs, months after advocacy groups complained that management problems were interfering with patients’ access to life-saving medications.

The abrupt ouster of the state’s contract with Michigan-based A.J. Boggs surprised patient advocates, many of whom learned about the change on a state conference call Wednesday morning. A termination letter was sent to A.J. Boggs just before the meeting.

Contracts with two other companies that run other parts of the state’s AIDS Drug As-

sistance Program will remain in place. A.J. Boggs officials did not immediately respond to requests for comment.

Public health officials said that starting Monday, enrollment services that had been provided by A.J. Boggs will be handled in-house by state employees. A.J. Boggs has until the end of the month to transfer patient records to the state.

“This is definitely the right move, and something we’ve been calling for for several months,” said Courtney Mulhern-Pearson, senior director of state and local affairs with the San Francisco AIDS Foundation. “We’re pleased that the state has been listening and is taking decisive action to improve the system for clients.”

Other patient support groups, though supportive of any move to improve the drug assistance program, said they were wary of yet another shift in management.

“We’ve been in a constant state of flux or uncertainty” since A.J. Boggs took over last June, said Chuan Teng, managing legal director at Positive Resource Center in San Francisco. “This is now another major uncertainty for our clients and for us.”

In a statement released Wednesday afternoon, the state public health department said it ended the contract with A.J. Boggs due to “material breaches of contract.” Among other problems, the state said A.J. Boggs was unable to provide a working online portal for enrollment. A portal that went up last summer was taken down in November due to security concerns.

A.J. Boggs and two other companies took over a program that had been managed by Oakland-based Ramsell Corp. for nearly 20 years.

The program covers all or a portion of medication costs for roughly 30,000 low-income Californians with HIV or AIDS. It is part of a federal network created in 1987 to help states pay for the first antiviral drugs to treat HIV; the program now covers costs for more than 200 drugs.

Even before the contract changed hands last June, patient advocacy groups told the state they were concerned that the change would cause interruptions in patient care and access to drugs. In the months that followed, patients across the state reported frustrations with enrolling in the program and getting their HIV medications in a timely manner.

The state and its contractors, along with hundreds of nonprofit caseworkers, scrambled in response, developing workarounds to help get patients enrolled and even providing emergency stashes of HIV drugs when patients ran out.

In December, state Sen. Scott Wiener, D-San Francisco, sent a letter to public health officials demanding that problems with the program be fixed or that one or more contracts with the new operators be canceled.

“The whole situation has been a disaster,” Wiener said Wednesday. “Obviously there is still work to do to restore full service to these HIVpositive patients, but this is a positive step. We’ll continue to monitor the situation very closely.”