State Fires Contractor After Problems Put California HIV Patients At Risk

Loren Jones takes antiretroviral drugs to suppress her HIV viral load. (Heidi de Marco/KHN)

California’s public health department Wednesday fired the contractor responsible for enrolling patients in a state-run AIDS program, saying its poor performance threatened enrollees’ access to life-saving medications.

The state announced it had terminated the contract with A.J. Boggs & Company because of several “material breaches,” including the failure to keep an online enrollment portal working properly. The department said in a written statement that the company also neglected to provide notice before hiring a subcontractor to provide services.

The state’s contract with Michigan-based A.J. Boggs began last July, when the California public health department decided not to renew the previous contractor, Ramsell Corp. Another company, Magellan Rx Management, of Arizona, got a contract to take over the pharmacy benefit services. It will continue to provide those services.

The department said it switched contracts to reduce administrative fees and drug reimbursement rates.

A.J. Boggs’ CEO Clarke Anderson declined to comment for this story.

The termination of the company’s enrollment contract followed a report in January by California Healthline and Kaiser Health News that patients were unable to get necessary drugs and timely care.

The AIDS Drug Assistance Program, overseen by the public health department, helps nearly 30,000 low-income HIV and AIDS patients in California pay for medications, insurance premiums and medical care.

Public health department officials said Wednesday they planned to determine eligibility and enroll patients directly rather than contract with a new company to do so. It wasn’t clear how long the state would manage these services in-house, but the department’s statement said it was “exploring all long-term options.”

The departure of A.J. Boggs was welcomed by advocates across the state, who for months had been lobbying state officials to fix problems with enrollment and access, said Courtney Mulhern-Pearson, director of state and local affairs for the San Francisco AIDS Foundation.

“We are pleased that the state was able to make such a decisive move. This was necessary and what we have been asking them to do for a while,” she said. “We are cautiously optimistic this is going to be a good fix for the program.”

Mulhern-Pearson said advocacy groups were notified during a Wednesday morning conference call about the decision to end the contract with A.J. Boggs. She said she believes it will be more efficient for the state to determine eligibility and enroll patients in-house. “I am hoping this will mean less communication breakdown,” she said.

AIDS service providers began reporting problems soon after A.J. Boggs took over enrollment. Patients were turned away by pharmacies and had to postpone medical procedures, they said. Some were dropped from the program for no apparent reason, according to the San Francisco AIDS Foundation and APLA Health.

In November, the state shut down the online enrollment system because of security breaches. Enrollment workers from HIV and AIDS service organizations had to send in applications by fax.

The public health department said Wednesday it hired an independent consulting firm to help create a new system and plans to begin training enrollment workers the week of March 13.

State Sen. Scott D. Wiener (D-San Francisco), one of several legislators who wrote a letter late last year to the public health department insisting the problems be fixed, said in an email Wednesday that the contract termination is an “important first step.”

“Now, the Department needs to make system changes to ensure that HIV patients get the medication they need to survive and be healthy,” Wiener wrote.

Consistent medical care and access to medication are critical for keeping HIV and AIDS patients healthy and reducing the spread of the disease.