RD17 - Healthy Lives Prescription Assistance Program

Executive Summary:


Authority for Study

House Bill 2225 and Senate Bill 1341, identical bills, enacted during the 2003 General Assembly Session amended the Code of Virginia to establish the Healthy Lives Prescription Assistance Fund under the auspices of the Secretary of Health and Human Resources to “accept appropriations, donations, grants, and in-kind contributions to develop and implement programs that will enhance current prescription programs for citizens of the Commonwealth who are without insurance or the ability to pay for prescription drugs and to develop innovative programs to make such prescription drugs more available." In addition, HB 2225 and SB 1341 include a second enactment clause that requires the Joint Commission on Health Care to prepare a Plan “to provide prescription drug benefits for low-income senior citizens and persons with disabilities…."

To develop recommendations for the Plan, a diverse group of interested parties, representing advocacy groups, health care providers and associations, pharmaceutical manufacturers, state agencies, and the Secretary of Health and Human Resources participated in workgroup meetings during the summer of 2003. Based on recommendations from this group, JCHC on November 12, 2003 unanimously approved a two-phased design for the Healthy Lives Prescription Plan.

Phase I included such activities as informing seniors and their families regarding the existence of pharmaceutical discount cards and affiliating with opportunities that currently exist in the community to provide assistance in filling out applications.

Implementation of Phase II included the following activities:

• Monitoring the actions of Congress regarding a Medicare prescription drug benefit;
• Examining what other states are doing to assist seniors;
• Encouraging Virginia-based initiatives such as The Pharmacy Connection;
• Continuing to develop partnerships with community-based entities such as pharmacies, faith-based organizations, human service agencies, and advocacy associations; and
• Analyzing potential legislation to increase the income limits for Medicaid eligibility in Virginia.

Actions Taken by JCHC

Ten policy options were offered for consideration by the Joint Commission on Health Care. On November 15, 2004, the Commission voted in support of six of the options including:

• Option II: Introduce a joint resolution requesting the Virginia Department for the Aging and the Virginia Department of Health to provide information on the “wrap around" coverage currently offered by private pharmaceutical companies. This coverage is available for low-income individuals enrolled in the Medicare prescription drug discount card program who use all of their $600 transitional assistance credit.

• Option IV: Introduce a budget amendment (language and funding) to expand the use of The Pharmacy Connection software to other areas of the state.

• Option V: Introduce a joint resolution requesting the Department for the Aging, the Department of Medical Assistance Services, and the Department of Health to work with the Virginia Dental Association and the Virginia Health Care Foundation in exploring the feasibility of using the Mission of Mercy initiative as a vehicle for expanding access to and information about pharmaceutical assistance programs and Medicare prescription drug discount cards.

• Option VIII: Continue to address the development of the Healthy Lives Prescription Plan by including the issue on the JCHC workplan for 2005.

• Option IX: Introduce a budget amendment (language and funding) to increase funding for the acquisition and provision of prescription medications to Free Clinic patients.

• Option X: Introduce a budget amendment (language and funding) to increase funding for the Virginia Primary Care Association Indigent Pharmacy Assistance Program.

[See also RD93, 2006.]