The Illinois Department of Public Health (IDPH), Office of Health Protection, Division of Infectious Disease, HIV/AIDS Section, and the Ryan White Part B Program (RWPB) has been closely following the COVID-19 outbreak. The Illinois RWPB takes its responsibility to support the needs of our clients and providers very seriously; and the program is committed to continuity of services in the event of any crisis.
Over the past several months, the RWPB Program, ADAP-Medication Assistance Program (MAP), and Premium Assistance Program (PAP) have been working with our partners to ensure we are all implementing pre-established business continuity and pandemic contingency plans, working in accordance with guidelines set by the Centers for Disease Control and Prevention, the U.S. Department of Health and Human Services, and the World Health Organization.
To date the RWPB Program is able to share the following information related to services provided throughout the state of Illinois:
- Management has been working closely with all HIV drug manufacturers to determine if there are any anticipate gaps in supply with any HIV medication entering the distribution pipeline. To date, all HIV drug manufacturers have confirmed there are no HIV drug manufacturers that anticipate any concerns to the supply of any HIV products, including those in HIV and hepatitis portfolios.
- Management has also been monitoring insurance plans to the best of our ability. A good overview of some of the policies that have been implemented by a variety of commercial insurers in response to COVID-19 outbreaks in the U.S. can be found here.
- Management has also been in discussion with the RWPB’s drug wholesaler, Cardinal Health Incorporated, and they have ensured IDPH that in an abundance of caution and for the protection of patients they have implemented a holistic approach to their emergency preparedness on several fronts. More specifically, Cardinal Health has implemented a fair share allocation process to ensure all primary customers have access to supply of the available products on hand, which means customers will be limited to ordering only 10% above their customary and normal utilization. For additional information, please see our COVID-19 customer microsite for Cardinal Health.
- Management has been in ongoing discussion with our contracted dispensing pharmacy, CVS Specialty Healthcare who has ensured IDPH that its organization has operationalized pandemic emergency preparedness protocol and they do not see any dispense ordering issues or shortage with their drug supply. For additional information, please visit to CVS Specialty Pharmacy.
- Finally, as it pertains to the Illinois RWPB Care Services, which provides critical medical assistance to Illinoisans living with HIV/AIDS related to core medical services and support services. As many are aware, the RWPB Program just completed its competitive grant cycle for its lead agent and other directly funded grantees. At this current time the program is working with IDPH’s senior management to develop protocol that ensures continuity of services as this new portfolio rolls out. There will be further guidance coming very shortly.
On a final note, earlier today, our IDPH HIV Prevention Program team disseminated the following information that RWPB believes beneficial for our community of clients and providers and wishes to share with stakeholders. Thank you in advance for IDPH’s prevention team in compiling the following information:
While federal and state public health agencies provide technical guidance, risk-management is ultimately an agency decision and a personal decision. As the COVID-19 epidemic evolves over time and as better information becomes available, risk management decisions should evolve as well.
Agencies should consider a number of factors in their risk-management decision-making. Agency location is one important factor. Agencies located or conducting outreach in or near counties with large numbers of COVID-19 diagnoses face a greater probability of encountering a person infectious for COVID-19. Agencies serving counties with no reported diagnoses to date may face a lower probability of encountering an infectious person. However, in the absence of widespread testing, the actual geographic distribution of COVID-19 infections is not well defined. Site types must be considered as well. Sites where clients are served individually may pose less risk than outreach settings where people gather in greater numbers. Meeting with clients at sites where handwashing facilities are available and where surfaces may be sanitized by providers after each session may pose less risk than sites lacking handwashing facilities where surface sanitation is less easily maintained. Besides location, an agency’s service types are a consideration. Some agencies provide only individual level services, others group level services, others community level interventions. In areas with COVID-19 prevalence, interventions requiring greater numbers of close personal contacts will increase the odds of an exposure. Grantees should notify IDPH grant monitors or lead agencies of any service changes.
In addition to agency-level planning, individuals should also review the COVID-19 guidance below to make individually appropriate risk management decisions. Based on age and pre-existing medical conditions, individuals vary in their own level of vulnerability and in the vulnerability of their family members to COVID-19 infection. What might be an acceptable level of risk for most of an agency’s staff may pose an increased threat to an individual provider based on personal and family circumstances.
Below are links to CDC guidance on Prevention of COVID-19 infection in community settings, for people experiencing viral symptoms, and for vulnerable persons.
Coronavirus Disease 2019 (COVID-19)
- Older adults
- People who have serious chronic medical conditions like:
- Heart disease
- Lung disease
- Compromised Immunity
Q: Should providers be wearing masks?
- The decision to wear a mask during service delivery is an agency and individual level decision.
- To date, CDC guidance does not recommend wearing masks in public settings, even for people at risk of more serious COVID-19 illness.
- CDC guidance does recommend that symptomatic persons with suspected exposure to COVID-19 wear masks until the condition in ruled out.
- CDC guidance does recommend that health care provider treating patients with diagnosed or suspected COVID-19 wear masks.
Q: Should providers be limiting or ceasing services?
- The decision to limit or stop some or all service delivery is an agency and individual level decision. Grantees should notify IDPH grant monitors of any service changes.
- Agencies should consider the likelihood of local COVID-19 prevalence, site characteristics, and service type characteristics in their risk-management planning.
- SARS-COV2 and COVID-19 Update for People Living with HIV (PLHIV).
- Guidance provided at the Conference on Retroviruses and Opportunistic Infections (CROI 2020) by John T. Brooks, M.D., a medical epidemiologist with the Division of HIV/AIDS Prevention at the U.S. Centers for Disease Control and Prevention (CDC)
- UPDATED: What People With HIV Need to Know About the New Coronavirus (especially see the comments in the second half of the article from Steve Pergam, MD, MPH, of the Vaccine and Infectious Disease Division at Fred Hutchinson Cancer Research Center)
- World Health Organization: Coronavirus disease (COVID-19) advice for the public: When and how to use masks
As new guidance and information comes to light, the Illinois RWPB Program will ensure we transmit that information to our network of clients and providers. Please do not hesitate to reach out to the Program with any questions.