2. ADAP Technical Assistance (TA) Materials
This chapter lists the available written materials published by the Health Resources and Services Administration (HRSA) to assist AIDS Drug Assistance Program (ADAP) grantees in managing their programs. Information on how to order these documents is also included.
A wide range of technical assistance materials on ADAP-related issues have been developed for use by grantees, advisory committees, physicians, and all those involved in ADAP services. These materials were developed in response to the rapidly changing environment of AIDS Drug Assistance Programs (ADAPs) and the ongoing need for States to better manage limited resources while facing increasing demand.
This section presents a concise directory of the most useful resources to provide assistance with ADAP programs. As additional materials become available, this list will be updated and expanded.
On-Site Technical Assistance TOP
On-site technical assistance (TA) is available to the Health Resources and Services Administration's (HRSA) HIV/AIDS Bureau's (HAB) ADAP grantees requiring support and guidance in strengthening their programs.
For more information on the process for requesting on-site TA, please see Section VIII, Chapter 1 of this manual.
ADAP Fact Sheets TOP
Six ADAP fact sheets present general program information and State-by-State breakouts on certain program characteristics. The fact sheets are entitled:
Cost-Containment Strategies; and
The Section 340B Drug Discount Program.
These publications are updated quarterly and provide explanations of the major issues currently facing ADAPs. Most ADAP fact sheets also provide State-by-State breakouts of program information. For example, "Funding Overview" lists each State's total ADAP resources, including Title II base funds, ADAP supplemental award, Title I contribution, State revenue, and cost-saving resources. These up-to-date charts may assist ADAPs and Title II program directors in assessing their programs by comparing them to those in other States.
The most recent ADAP fact sheet, "The Section 340B Drug Discount Program," describes the two methods available to ADAPs for accessing the Section 340B Drug Discount Program: the point of purchase discount and the rebate option. For more information about the Section 340B Drug Discount Program, please see Section VII of this manual.
ADAP Monthly Report TOP
In February 1998, HRSA implemented the ADAP Monthly Report (AMR), a new data collection system for State ADAPs. On a monthly basis, participants report on clients, expenditures, and any major changes to their State ADAP. The ADAP Monthly Report was made available via the Internet in March 2001. These monthly collections allow HRSA to more accurately monitor the rapid growth in client utilization, program costs, and changing patterns of enrollment and program use. In addition, information on the prices paid by State ADAPs for common HIV pharmaceuticals is collected on a quarterly basis.
From this AMR data, HRSA generates reports highlighting individual programs, comparisons between ADAPs, and aggregate nationwide trend analyses. These reports reflect the most up-to-date information on State ADAPs and demonstrate recent patterns and changes at the State level.
As of April 1, 1999, participation in the AMR data collection system became a Condition of Award for Title II ADAP grantees. Participation in the AMR allows HRSA to get a complete picture of national ADAP trends, as they occur throughout the year. In addition, a 100 percent submission rate gives HRSA the data necessary to assess the cost savings from the 340B Drug Discount point of purchase program and rebate option. The AMR is now available online.
ADAP Conference Call Reports TOP
HRSA's AIDS Drug Assistance Program arranges the ADAP teleconference series. This conference call series is designed to:
Each conference call usually begins with an update on DSS and ADAP activities. Selected panelists—Title II/ADAP State representatives, HRSA officials, or other experts on the topic—then address the topic of the call by giving short presentations on the issue from their individual perspectives. The presentations are followed by a question-and-answer session, which allows listeners an opportunity to ask questions of the panelists, to share their own successes or challenges, and to provide feedback or comments on the discussion.
Conference call summaries are distributed to all registered participants and are available through the TA Library.
ADAP Forum TOP
The AIDS Drug Assistance Program (ADAP) developed an electronic bulletin board for State and Territory ADAPs. This bulletin board serves as an effective medium for State and Territory ADAPs to facilitate peer-to-peer communication and communication with the HIV/AIDS Bureau/Division of Service Systems/AIDS Drug Assistance Program's Central Office. Designed as a "working forum," it is dedicated to addressing the special problems and concerns of State ADAPs. The ADAP Branch uses the bulletin board to disseminate information to Grantees in a timely manner and to solicit feedback on pertinent ADAP issues that affect service delivery. Membership for use of the bulletin board consists of Division of Service Systems management staff, ADAP Branch staff, HRSA Regional Title II Project Officers and ADAP Grantees.
Other ADAP-Related Reports TOP
ADAP TA documents provide useful information for grantees as they work to maximize limited resources and improve access to HIV/AIDS treatments. Documents currently available are described below.
Drug Pricing, Purchasing, and Distribution Systems, 1997
This report offers an overview of the various drug purchasing and distribution cost-containment strategies that are available to ADAPs. It includes a review of the guidelines that govern the implementation of Section 340B of the Public Health Service Act and a presentation of ADAP models that facilitate participation in the Section 340B Drug Discount Program.
The 1997 report is no longer in print. A revised version of this document--including important information about the Section 340B Drug Discount Program, including the ADAP rebate option-can be found in this manual.
ADAP State profiles provide HRSA and grantees with "snapshots" of individual State ADAP programs. These two-page documents include information on an ADAP for the current year and the preceding two years. These data highlight a program's patterns and changes in many program areas. Such categories of information include funding resources, formulary composition, financial and medical eligibility criteria, client utilization, cost-saving strategies, the use of ADAP funds for Access, Adherence and Monitoring services, health insurance programs, and Medicaid coordination.
HRSA generates State profiles from its ADAP database, which stores ADAP information as provided in the annual Title II Grant Application. Information submitted by grantees on the AMR--such as formulary additions and changes in eligibility--are reflected in the State profile as well.
Coordination Strategies Between State ADAPs and Medicaid, 1998
This report provides an overview of the methods of coordination between ADAPs and State Medicaid programs. Several ADAPs with successful models of Medicaid coordination are highlighted, with particular emphasis on the transfer of clients between the two programs and the process of retroactive billing.
How to Order These ADAP TA Materials
To obtain any of the documents listed in this chapter, please call the Division of Service Systems at (301) 443-6745 and ask to speak to a member of the ADAP Branch staff.
Sources Used for This Chapter
HRSA, HAB, Division of Service Systems. "Section V: Title II Program Categories, Chapter 6: AIDS Drug Assistance Program (ADAP)." Title II Manual. Rockville, MD: U.S. Department of Health and Human Services, 1999, revised 2002.