The purpose of this memo is to notify ADAP and PrEP-AP enrollment workers of updates to the ADAP TAP Request Form (CDPH 8728) and PrEP-AP TAP Request Form (CDPH 8740). These forms are used to request a TAP for ADAP and PrEP-AP applicants who are unable to provide documentation to substantiate eligibility. An approved TAP grants the applicant 30-days of ADAP or PrEP-AP temporary eligibility to obtain and submit required documentation to a certified ADAP/PrEP-AP enrollment worker.  

With the new variant of Coronavirus (COVID-19) epidemic rapidly spreading, we understand that some enrollment sites are not providing in-person services and some clients do not have access to fax or email their supporting documentation. In order to assist clients who are unable to send documentation via email or fax, the TAP forms for ADAP and PrEP-AP have been updated to include a section for enrollment workers to complete when attesting that they screened the client for eligibility over the phone and are placing them on a TAP.

Below you will find instructions for enrollment workers who are not providing in-person services and clients that do not have access to submit supporting documentation via fax or email:

1. The client should be placed on a TAP. The enrollment worker will need to complete the updated TAP form and must enter the following case note in the AES: "Enrolled client over the phone and placing on a TAP. Unable to collect documentation from client at this time due to COVID restrictions and clients inability to fax or email required documentation." Reasonable effort should be made to collect the documentation before the end of the TAP.  

2. If the documentation cannot be secured, the enrollment worker can clear the TAP by submitting a blank supporting document and must enter the following case note in the AES: "Unable to collect documentation from client at this time due to COVID restrictions and clients inability to fax or email required documentation." If a case note is not included, the client will be at risk for losing eligibility once OA completes secondary review.

3. Enrollment workers are required to inform the client that documentation will need to be collected prior to the end of their 12-month eligibility span. Enrollment workers must also vigorously pursue (defined as making and documenting at least 3 outreach attempts to the client) the client to collect the required documentation.

Mail Enrollment

Mail enrollment is an option for those who do not have the ability to fax or email documents. For enrollment workers who are able to provide this option to clients, enrollment workers must:

1. confirm the client's mailing address.
   

2. enter a case note documenting that the client requested mail enrollment and you confirmed their mailing address.

3. include a self-addressed envelope for the client to use when sending the forms back.

4. mail the self-addressed envelope and blank ADAP/PrEP-AP forms placed within a sealed envelope with no picture windows on the envelope and, if possible, have the wording "confidential" and "to be opened by addressee only" on the front of the sealed envelope.

Electronic Signature Reminder

Electronic signatures are allowable as long as the method used is reliable and not likely to lead to false signatures. OA has determined that the Adobe PDF digital signature feature and DocuSign meet this requirement.

OA created directions for clients on how to create a Digital ID in Adobe to sign forms. In addition, OA has enabled digital signatures on all forms that require a signature from clients. The directions and forms are available on the Enrollment Worker SharePoint, linked here:

ADAP forms

PrEP-AP forms

Create a Digital Signature Directions

If you have any questions, please contact your ADAP Advisor.

Thank you,

Sharisse Kemp

ADAP Branch Chief

California Department of Public Health