Testimony on the Section 1115 Medicaid Redesign Team Waiver Submitted by Richard Fowler
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Testimony on the Section 1115 Medicaid Redesign Team Waiver Submitted by Richard Fowler

Jan 21, 2021

Good afternoon and thank you for this opportunity to provide comment.  I am Richard Fowler, my pronouns are he and him, and my comments are specific to the proposed pharmacy carve out in the 1115 waiver extension request.

I am the Consumer Relations Coordinator, as well as a patient living with HIV for over 2 decades, at Trillium Health, located in Rochester, New York, where we serve over 7,400 patients in Greater Rochester and Finger Lakes regions.

Founded to provide clinical and supportive services to persons living with HIV and AIDS over 30 years ago, Trillium Health today is a Federally Qualified Community Health Center (FQHC) Look-Alike that provides extraordinary care for people from all backgrounds, regardless of income, sexual orientation, gender identity, race, or ethnicity.

As we are well aware, the 340B program was established by the federal government in 1992 to help safety net providers serve people who would otherwise fall through the cracks.

Last year, the New York State budget included a little-noticed provision that would carve the pharmacy benefit out of Medicaid managed care and replace it with a fee-for-service model as a “cost savings” measure leading to the MRT 1115 Waiver Request we are discussing, which if approved will have a devastating impact on Trillium Health and many other healthcare providers across the state.

Without the 340B savings, Trillium Health will lose more than $5 million annually, forcing us to reduce or eliminate many of our basic services – including food, housing, transportation and care coordination.

It’s a fact that someone who doesn’t have food or a stable place to live is not worried about taking their antiretroviral therapy.   People who can’t afford a bus ticket aren’t able to get to medical appointments.

Trillium Health depends on the ability to buy prescription medicine at a reduced price through the federal 340B drug discount program in order to provide comprehensive, wraparound healthcare services at little-to-no cost to our patients.

As Chair of the Rochester Area Task Force on AIDS and a member of the Core Leadership Team for Monroe County Partnering to End the Epidemic, I can assure you that:

  • Without these services HIV rates will rise, thwarting the strides we have made toward Ending the HIV Epidemic in New York, and our patients will be the ones who lose.
  • Communities of color will be disproportionally impacted – exacerbating health inequities and leading to poorer health outcomes, specifically for low-income families.

The bottom line is that the reduction of 340B savings will have a devastating impact across New York.

It will threaten our patients living with HIV, and it will undermine our success in addressing health disparities, particularly within communities of color, in the midst of a global pandemic.

Thank you for your time.