In collaboration with the Health Resources and Services Administration (HRSA) and as a component of our HRSA Cooperative Agreement, NASTAD is releasing a set of videos related to AIDS Drug Assistance Program (ADAP) efficiency and program management. These videos are a companion to the ADAP Technical Assistance (TA) brief series released in winter 2012. Throughout the course of the past year, NASTAD compiled lessons learned from ADAP coordinators on a variety of topics including the use of data, implementation of cost-containment measures, challenges and successes in managing an ADAP, and advice for working within the program. The videos being released today address challenges and successes in management and ADAP and include advice from seasoned ADAP coordinators for working within the program.
These videos contain personal stories and sage advice from ADAP coordinators who have first-hand experience on the topics being presented. The videos represent a glimpse inside the complex world of ADAP through the lens of individuals who strive every day to ensure those needing services can continue to access them. NASTAD would like to thank Jeff Maras (Illinois), Holly Hanson (Iowa), Annette Rockwell (Massachusetts), Chris Hanson (Michigan), John Furnari (North Carolina), Noreen O’Donnell (South Carolina), Dwayne Haught (Texas), and Jay Adams (West Virginia) for their time and contributions to this project.
Chris Hanson: What It Means To Be an ADAP Coordinator
As an ADAP coordinator, I have been afforded the aerial view of a very complex, fragmented, healthcare delivery system. As a program that serves people living with HIV that are trying to navigate these fragmented systems, ADAP is charged with providing access. Providing access has been historically defined specifically around providing access to medication in the most cost-effective manner. As the ADAP Coordinator, I travel the entire spectrum of care and also witness the success in working directly with clients to address their needs.
I sometimes reflect that, from the outside, people do not always realize the magnitude of what our jobs are. Our roles are complex and span business, finance, accounting, social work and counseling. The tasks we are asked to perform and the gravity of the work that we do is unending and seemingly insurmountable. Our purpose is never stagnant because ADAP is in a unique position. Unlike other healthcare delivery systems, ADAP provides information to people, but also the tools to use the information and assistance in using those tools. ADAP staff, overall, provides education, making the system of care better and helping people to understand the care process more deeply. While our charge is to provide access to medications, our goal is to use access to medications as a tool to help our clients get into care and be educated and resourceful so they can navigate the system and stay in care.
The education ADAP provides comes in many forms. We ensure that we are meeting program requirements – budgeting appropriately to ensure that we can live up to the goals we outlined in the information we provide to clients. We are also counselors and mediators; I have learned over the years that it is important to meet the clients where they are and not jump into help mode until I can reach a common ground with the person I am talking to. More often than not, clients just need to know we hear their voice, and though ADAP is not a “fix all” to many of the problems, we can listen. Sometimes just listening is cost-containment, and a tool for retention in care – both of which ensure a healthier community. In a world driven by policies, I need to understand the circumstances of the individual seeking ADAP services before I can fully understand and communicate how those services will benefit that person. The time it takes to engage with a client is incredibly worthwhile in saving scarce resources and making a person feel valued.
At its core, our job is to be human to fellow human beings in an environment that constantly pushes us to the limits of labels – ID numbers, unique identifiers, dollar signs, HIV-positive, gay/lesbian/transgender, black/white/Hispanic, etc. We have to “care” before we can expect our community to seek care. We hope the videos above provide insight into the inner-workings of an ADAP. Please visit the NASTAD website to view other ADAP TA resources. Please feel free to leave a comment below sharing your experiences as well.