RD95 - HB 2225/SB 1341 (2003) Healthy Lives Prescription Assistance Plan Final Report

Executive Summary:

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 included 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.

During the 2005 General Assembly Session, three joint resolutions and three budget amendments were introduced by the Joint Commission to provide information about and funding for prescription assistance programs. HJR 701 to encourage the Department for the Aging and the Department of Health to include information about “wrap-around" coverage offered by some private pharmaceutical companies, and
HJR 702/SJR 363 to encourage distribution of information about prescription assistance programs through the Mission of Mercy program were adopted by the General Assembly. Likewise, the three budget amendments to provide prescription assistance funding to benefit low-income Virginians through programs offered by the Virginia Health Care Foundation, free clinics, and community health centers were included in the 2005 budget approved by the General Assembly.

In November 2005, JCHC voted to focus on addressing the implementation of Medicare Part D and its effect on Virginia’s senior and disabled citizens. This decision was based on several factors. First, the Healthy Lives Prescription Assistance Fund had received no funding. Second, passage of the Medicare Prescription Drug, Improvement and Modernization Act in establishing Medicare Part D had addressed the needs of many Virginians who had previously lacked prescription coverage. Third, several JCHC-introduced budget amendments, to increase funding for prescription assistance to uninsured Virginians by $950,000 per year, were included in the budget approved during the 2005 General Assembly Session. Consequently, this is the final report of the Joint Commission on Health Care regarding the Healthy Lives Prescription Assistance Plan.

JCHC Staff for this Report
Catherine W. Harrison
Senior Health Policy Analyst