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EDMUND G. BROWN JR.
Governor

State of California—Health and Human Services Agency
California Department of Public Health


ADAP MM 2020-17
June 1, 2020


TO:
PREP-AP CLINICAL NETWORK PROVIDERS AND
PREP-AP ENROLLMENT WORKERS

SUBJECT:
ENROLLING MINORS AND CLIENTS WITH CONFIDENTIAILTY CONCERS INTO PREP-AP

​ADAP MANAGEMENT MEMO 2020-17: ENROLLING MINORS AND CLIENTS WITH CONFIDENTIAILTY CONCERS INTO PREP-AP


Overview

The purpose of this memo is to inform PrEP-AP clinical network providers and enrollment workers of an expansion of the PrEP-AP. Effective June 4, 2020, minors between the ages of 12 and17 can be enrolled into the PrEP-AP as uninsured clients.

Also effective June 4, 2020, clients 18 years of age and older who have insurance through a parent, spouse or registered domestic partner, and want to enroll into the PrEP-AP, but have concerns about their confidentiality, may be enrolled into the program as uninsured clients.

These clients will not be required to enroll into the Gilead assistance program. In addition, to ensure client confidentiality, physical mail will not be mailed to clients. All necessary information can be obtained through the Client Portal, including access to their Magellan Rx (MRx) and Pool Administrators, Inc. (PAi) identification cards.

Requirements for Enrolling into the PrEP-AP

Income documentation is not required for minors or clients who have confidentiality concerns.

Minors

• Be between the ages of 12-17; and

• Have a negative HIV/AIDS test result (dated within 6 months of the PrEP-AP application)

Clients Who Have Confidentiality Concerns

• Be at least 18 years old;

• Be a resident of California; and

• Have a negative HIV/AIDS test result (dated within 6 months of the PrEP-AP application)

Enrolling into the PrEP-AP

Minors and clients enrolling into the PrEP-AP as uninsured due to confidentiality concerns will need to visit a PrEP-AP enrollment site to complete the Request for Services form. This form is used in place of the regular PrEP-AP application and is attached to this memo. The enrollment worker will also assist the client with setting up access to the Client Portal by contacting the Client Services Call Center at 844-421-7050. This will allow the client to obtain eligibility information in addition to accessing their MRx and PAi identification cards from their smart phone or computer. If the client wants a physical identification card, the enrollment worker can print the card for the client from the ADAP Enrollment System.

All clients must provide a negative HIV/AIDS test dated within six months of the PrEP-AP application. Clients over the age of 18 years old must also provide residency documentation.

If a minor or client with confidentiality concerns does not have lab results, they will be placed on a Temporary Access Period (TAP) which grants the client 30 days of eligibility and the client will be referred to a PrEP-AP Network Provider for an assessment and HIV test. Minors and clients with confidentiality concerns will also be able to utilize the PrEP-AP’s telemedicine provider, PlushCare.

Re-Enrolling into the PrEP-AP

Minors will be required to re-enroll into the PrEP-AP annually. Minors will need to visit a PrEP-AP enrollment site to complete the Request for Services form and complete re-enrollment.

Clients who were enrolled in the PrEP-AP program as a minor, and re-enroll for the first time after their eighteenth birthday will be required to provide proof of residency, income documentation, provide a negative HIV/AIDS test dated within six months, and enroll in the manufacturer’s assistance program (if eligible), unless the client still meets criteria to enroll due to concerns with their confidentiality (see below).

Please Note: After turning 18, if the client is re-enrolling in PrEP-AP as uninsured due to confidentiality concerns, the client will need to follow the steps outlined below for re-enrollment.

Clients re-enrolling into the PrEP-AP as uninsured due to confidentiality concerns will need to complete the Request for Services form, provide residency documentation and a negative HIV/AIDS test dated within six months of the PrEP-AP application.

Medical Out-of-Pocket (MOOP) Benefit

Minors and clients who have confidentiality concerns are eligible for the MOOP benefit. The PrEP-AP will only provide assistance with PrEP-related medical costs for the prevention of HIV and treatment of sexually transmitted infections (STIs). Since they are enrolled as uninsured, these clients must receive services from clinical providers within the PrEP-AP Provider network. The list of allowable medical services and network provider locator can be found on the PrEP-AP Resources page.

If you have any questions regarding the information provided in this memo, please e-mail the PrEP-AP inbox at PrEPSupport@cdph.ca.gov.


Thank you,
Sandra_Robinson_E_Signature.jpg
Sandra Robinson, MBA
ADAP Branch Chief
California Department of Public Health



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