WINTER 2016

Virology Newsletter

The Iowa Wellness Plan will be changing in the coming calendar year. The Iowa Department of Human Services (DHS) announced winning bidders for Governor Branstad’s Medicaid Modernization initiative that will be effective March 1, 2016.

Amerigroup Iowa, Inc. (1-800-600-4441)

AmeriHealth Caritas Iowa, Inc. (1-855-332-2440)

UnitedHealthcare Plan of the River Valley, Inc. (1-800-464-9484)

The initiative aims to:

Improve quality and access

Promote accountability for outcomes

Create a more predictable and sustainable Medicaid budget

All three MCOs will continue to contract with all current Medicaid providers until August 2016. Begin-

ning August 2016, providers will have decided which MCOs they want to contract with and will have

created their “networks” accordingly. UI Health Care is working to contract with all Managed Care Or-

ganizations (MCOs). If you have questions about which company is best for you, we encourage you to

contact Iowa Medicaid Enterprise (IME) directly. You may email IMEMemberServices@dhs.state.ia.us or

call 1-800-338-8366, 8 a.m. to 5 p.m., Monday through Friday.

Please send your case manager any correspondence you receive from DHS referencing the Managed Care Organization you are assigned and we will be in touch regarding any changes that may be recom-mended as we receive more guidance from our Ryan White colleagues. We also have a virtual Medicaid Information Center that is available via email at medicaid-information@uiowa.edu

MEDICAID MODERNIZATION NEEDING TO KNOW MCO’S

New Virology Research Study We are excited to announce the beginning of a new research study in the Virology Clinic as of January 2016. The purpose of this study is to evaluate the use of pitavastatin to reduce the risk of CVD in adults infected with HIV who are on antiretroviral therapy (ART). Currently there are few strategies to prevent CVD in HIV-infected people, even though they are a high risk for developing CVD. Statin medi-cations are used to lower cholesterol and may be effective at reducing the risk of CVD in people infect-ed with HIV. The purpose of this study is to evaluate the use of pitavastatin to reduce the risk of CVD in adults infected with HIV who are on ART. Participants will be randomly assigned to receive 4 mg of pitavastatin or placebo once a day for the entire time they are enrolled in the study. Study visits will occur at study entry (day 0) and months 1 and 4. Starting at month 4, study visits will occur every 4 months for the rest of the study. Depending on when participants enroll, they will be in the study for a total of 3.5 to 6 years. Study visits will include medical and medication history reviews, physical exami-nations, blood collections, assessments and questionnaires and an electrocardiogram (ECG) (at study entry only). If you are interested in participating in this research study please contact your provider or call 319-335-7520.

Enrollment Open for Clear

VIROLOGY NEWSLETTER PAGE 2

Enrollment will be open very soon for those interested in participating in the client-centered program called CLEAR. CLEAR stands for: choosing life, empowerment, ac-tion, and results! The CLEAR program is open to persons living with HIV or at high risk of acquiring HIV who are interested in increasing or enhancing behaviors that promote healthy living, practice ways to effectively face challenges of daily living, increase posi-tive thoughts, feelings and actions as well as develop daily routines to stay healthy. Participation in CLEAR will involve at least 6 one-hour weekly sessions with a trained CLEAR counselor. Participants will be given incentives to attend weekly appointments. To learn more about screening and the enrollment process please call Katie Vodraska at 319-353-7173, email Katie at katie-vodraska@uiowa.edu, or contact your “case manager.”

New Antiretroviral (ARV) By Dena Behm Dillon, Pharm. D., AAHIVP

There’s a new form of tenofovir called tenofovir alafenamide, which provides higher drug levels in the cells where HIV replicates and lower levels in the blood. Because it concen-trates at the site of infection and gets much lower levels in the kidneys and bones, it ap-pears that this new form of tenofovir may lead to fewer kidney and bone side effects than the original version of tenofovir (disoproxil fumarate). So far, tenofovir alafenamide is only available as part of a combination tablet named Gen-voya®, which is similar to Stribild® (elvitegravir, cobicistat, emtricitabine, tenofovir). It is expected to be approved in two more forms in April and July of 2016…one similar to Com-plera® (rilpivirine, emtricitabine, tenofovir) and one similar to Truvada® (emtricitabine, tenofovir). In the future we'll likely be seeing it put into more products including in combi-nation with darunavir and dolutegravir. It will likely have the most value in people who have or are at high risk for side effects with tenofovir disoproxil fumarate, such as kidney toxicity or osteoporosis. AIDSinfo

PAGE 3 WINTER 2016

Tips for living better and longer with your virus Brought to you by the Ryan White Program

Let’s talk more about mental health! When living with HIV, mental illness can make it harder for you to take your medication on time, go to your health care appointments, and use your support network. Let’s explore some common myths about mental illness: Myth: Mental illness only affects a few people Fact: Mental illness is common. One in four people experience mental illness each year. Myth: Mental illness is caused by personal weakness. Fact: Mental illness is not a personal flaw. It is caused by genetic, biological, and social factors

Myth: People with mental illness never get better Fact: With the right kind of help, most people do recover and lead healthy, productive, and satisfying lives.

Myth: People with mental illness can “pull themselves out of it.:” Fact: A mental illness is not caused by personal weakness and is not “cured” by per-sonal strength.

Strategies to improve your mental & emotional health: Value Yourself: Treat yourself with kindness and respect, avoid self-criticism Surround yourself with good people: People with strong family or social connects are gen-erally healthier and happier Learn how to manage stress ( a normal part of life): Practice coping strategies; write in a journal, take a walk, step away from technology, and try to see the humor in life (laughing can relax your body, ease pain, and boost your immune system) Set realistic goals (personally and professionally): Aim high, but be realistic and don’t over schedule. You’ll enjoy a tremendous amount of self-worth as your progress towards your goal! Try new things: A change of pace can perk up your schedule and you may discover some-thing new that you love! Do things that positively impact others: Feeling useful to others and being valued for what you do can help boost your self-esteem. Adapted from “20 ways to live to be 100 When You Have HIV,” Michelle Garcia and Diana Anderson– Minshall, HIV Plus Magazine, January/February 2015.

Medicaid Formulary Changes By Tami Haught

CHAIN Community Organizer

(Community HIV/Hepatitis Advocates of Iowa Network)

PAGE 4

Goold Health Systems made a rec-ommendation to the Iowa P&T Committee to change the formulary status of Triumeq, Stribild, and Complera. The recommendation was to move each of these HIV drugs to a non-Preferred status, which will severely limit the access to each of these single tablet regimen products. Branded product Combivir was also moved to a non-Preferred sta-tus. The P&T Committee agreed on Aug 20th to ac-cept the recommendations. Senator Matt McCoy has contacted the state to de-termine how Medicaid can make these changes since there is a statute of protection for HIV medi-cations. He is very concerned that this move will limit access to HIV medications for new Medicaid

patients. I am reaching out to you to see if we may mobilize concerned patients and advocates to write letters to Iowa Medicaid and Goold Health Systems. The Georgian patient advocates partnered with HIV physicians to successfully get Georgia to reconsider their decision to restrict access to the HIV

class. Dr. Melanie Thompson’s Op Ed, which ran in the Georgia Voice, the premier media source for LGBT Georgia, is here: http://thegavoice.com/georgia-senator-lgbt-groups-criticize-health-department-on-hiv-meds-change/. A letter from the HIV Medical Association is here: http://hivclinician.org/wp-content/uploads/2014/11/Georgia-Medicaid.pdf As a resource for letters, Harvard’s Center for Health Law and Policy Innovation (CHLPI) creat-ed two Dept Of Insurance Templates which are in-tended to support the development of grievance letters from advocates/providers/consumers to state’s DOI regulators. The link to the templates is here: http://www.chlpi.org/download-chlpis-doi-templates/. Carmel Shachar, Director, Center for Health Law & Policy Innovation at Harvard is offering to assist with letters to Medicaid. She asked that I share her number with you – 617-390-2588.

HOUSE Speaker: Linda L. Upmeyer HD 54 1811 N. 8th St. Clear Lake IA 50428 Majority Leader: Chris Hagenow HD 43 1915 69th St. Windsor Heights IA 50324 Majority Whip: Joel Fry HD 27 1473 195th Ave. Osceola IA 50213 Minority Leader: Mark D. Smith HD 71 816 Roberts Terrace Marshalltown IA 50158 Chair of Human Resources Comm: Linda Miller HD 94 6766 Ridges Court Bettendorf IA 52722

Chair of Human Resources Budget Com: Dave Heaton

HD 91 510 E. Washington Mt. Pleasant IA 52641 Chair of Rules Committee: Dawn Pettengill HD 75 P.O. Box A Mt. Auburn IA 52313 SENATE President: Pam Jochum SD 50 2368 Jackson St. Dubuque IA 52001 Majority Leader: Michael E. Gronstal SD 8 220 Bennett Ave, Council Bluffs, IA 51503

Assist. Majority Leader: Matt McCoy SD 21 3808 River Oaks Drive Des Moines IA 50312 Assist. Majority Leader: Amanda Ragan SD 27 361 S. Penn. 1D Mason City IA 50401 Chair of Human Resources Budget: Liz Mathis SD34 1725 Mackenzie Drive Cedar Rapids IA 52411 Minority Leader: Bill Dix SD 25 1846 317 S Walnut Shell Rock IA 50670

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Day on the Hill At the Des Moines Capitol Building

(time is TBD)

Positive Iowans Taking Charge hosts the 2016Positive Iowans Taking Charge hosts the 2016Positive Iowans Taking Charge hosts the 2016 Wellness Summit May 13Wellness Summit May 13Wellness Summit May 13---15, 201615, 201615, 2016

The Wellness Summit provides a safe, non-judgmental environment for Iowans living with HIV/AIDS. The Wellness Summit is one way to help reduce the stig-ma and isolation that many people living with HIV/AIDS feel. The Summit is a source of encouragement, provides educational opportunities, camaraderie and a sense of community.

Applications will be available in March, please check our website at : www.pitchiowa.org or on PITCH’s Facebook page.

Scheduling

Have you recently received a call from the University of Iowa Hospitals and Clinics, reminding you or your upcoming appointment or asking you to schedule an appointment in our clinic because you have not been seen recently? If yes, then you have probably spoken to Nina Pliakos or Shayla Wesley– Shanks, our program assistants. Recently we have rolled out the retention and reengagement service to all clients and patients in our program. The purpose of this service is to ensure that each of our patients know that we are interested in their health care, remind our clients of their upcoming appointment and allow for you to make changes to your schedule if need be, without resulting in a no show/missed appointment. Shayla and/or Nina will call you 2-3 days prior to your scheduled appointment to remind you of your upcoming appointment in the Clinic. If you are not able to make your appointment, we ask that you make every effort to contact us as soon as possible at 319-356-8133 (Medicine Specialty Clinic) 319-335-7444 (Shayla), 319-335-7218 (Nina). We’d like to remind everyone that as winter approaches and you are cozy and warm in your home, please don’t forget to keep your HIV appointments! We understand there are a variety of reasons why patients are unable to make their appointments but to please let us know as soon as they are able to. Your cancellation might avert a visit to the ER for another patient, or allow another patient who is suffering to be seen earlier. And don’t forget to reschedule! Thank you in advance.

New to Clinic: Condom Dispensers Condom and lube dispensers have been added to our clinic rooms. Please don’t be shy, take as many as you like.

Receive Your Newsletter Electronically Many of you have opted to receive our quarterly newsletter via e-mail. Update us if you have changed your email contact information. If you are still receiving the newsletter via your home address and would like to have it e-

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Meet our New Field Benefit Specialist: I’m Angela Kappeler, soon to be Angela Speers, and I live in Oxford with my fiancé. We have two pup-pies that eat everything from doors to rocks, and the veterinarians unfortunately know us all too well. My love of animals came from growing up on a farm by Walcott, Iowa, but many people know it as the world’s largest truck stop. After graduating from the University of Iowa I went on to work in case man-agement in Johnson County investigating elder abuse and providing SHIIP counseling. I am so excited to be a part of the team, and I could not be happier working to help those in need. Please don’t hesitate to stop me and say hello, and I am always open to advice. I will be happy to help in any way that I can, and I look forward to working with each of you.

Changing Medicine, Changing

Lives! The University of Iowa Virology Program uses a multi-disciplinary approach to provide compre-hensive care including: social services and com-munity referrals, financial programs such as the Ryan White funds, psychiatry services, nutri-tion consultation, referrals to experience pro-fessionals in all medical specialties, medication, clinical trials, and specialized medical care. The staff understands confidentiality concerns. If you have questions, concerns, of if you have tested positive and want to schedule your first appointment, please call the Virology Clinic at (319) 335-7444.

The University of Iowa Virology Program Internal Medicine MRC 342

200 Hawkins Drive Iowa City, IA 52242

PAGE 7

Having trouble maintaining your

housing due to an emergent situation

such as job loss or illness? You may

be eligible for HOPWA assistance.

Please contact the HOPWA provider

in your area to see if assistance is

available. UIHC currently offers

assistance with long-term rental as-

sistance (TBRA), short-term rent,

mortgage, and utility assistance

(STRMU), and permanent housing

placement services (PHP) (deposit

HOPWA REMINDER

Medicine Specialty Clinic Scheduling

319-356-8133

Waterloo Outreach Scheduling

319-356-1533

Hospital Operator 319-356-1616

Tricia Kroll Social Worker

319-384-7307

Jennifer Keeler Social Worker, HOP-WA

319-467-5662

Katie Vodraska Social Worker, CLEAR

319-353-7173

Sarah Hambright Social Worker

319-353-8951

Angela Kappeler Field Benefit Specialist

319-335-7309

Nina Pliakos Research Assistant

319-335-7218

Shayla Wesley-Shanks Program Assistant

319-335-7444

Deb Pearson Program Nurse

319-335-7520

Wendy Sauter Program Nurse

319-335-7605