Hawai‘i State Department of Health

HIV Medical Management Services

Hawai‘i Department of Health
HIV Medical Management Service
(808) 732-0026 ( Honolulu number)

The Hawai‘i Department of Health provides the HIV medical management services to help people living with HIV and their doctors to monitor and maintain their health. Services are provided through three programs: HSPAMM, HDAP, & H-COBRA.

Hawai‘i Seropositivity & Medical Management Program (HSPAMM)

HSPAMM provides physician visits and a panel of HIV-related laboratory tests (including T-cell counts and viral load tests) for people in Hawai‘i living with HIV. The services are provided every six months at no cost to the patient. The purpose of the program is to:

Encourage people with HIV to access medical care as early as possible
Help patients and their physicians to prevent progression of HIV disease
Provide for monitoring of immune status and viral infection for people with HIV
Support primary care physicians in providing effective medical management for people with HIV

Who is eligible for HSPAMM? Anyone who is HIV positive and living in Hawai‘i is eligible. HSPAMM services are provided at no cost to the individual, regardless of income or other access to healthcare.

How does someone start getting HSPAMM services? Patients need to be enrolled by their physician. Because patients are never identified to the program, enrollment can only be done through the physician. Physicians can call HSPAMM at (808) 732-0026 (Honolulu number) to get new patient enrollment packets.

All Hawai‘i residents living with HIV, are strongly encourage to take advantage of these free services to monitor and help manage their health. HSPAMM participants access services through private physicians, and any physician can join the program. Participants fill out a questionnaire at each HSPAMM visit (once every six months). The program collects general information about participants (for example, age, gender, ethnicity, etc.), health related behaviors, symptoms, and medications. The participant's doctor reports health information to HSPAMM, and HSPAMM receives copies of the results of the laboratory tests (including, for example, T-cell count and viral load). All HSPAMM services are conducted using a code number instead of the participant's name. The HSPAMM program and the laboratory that process lab tests DO NOT receive any identifying information (like name, address, social security number etc). Only the participant's doctor's office will know who the person is and only the doctor's office can connect the HSPAMM code number to the individual participant.

[back to top]

HIV Drug Assistance Program (HDAP)

HDAP provides medication to Hawai‘i residents living with HIV, who have limited income and who cannot get HIV medications for any other sources. Medications are provided at no cost to the patient.

HDAP provides FDA-approved medications used to:

Treat HIV infection
Prevent and treat opportunistic infections
Treat HIV-associated anemia and wasting
Treat or improve side effects of HIV

The drugs that can be provided by HDAP are listed on the HDAP Formulary

Who is eligible for HDAP? To be eligible for HDAP, individuals must:

Live in Hawai‘i
Be HIV positive
Be under the care of a physician
Be unable to access medication through prescription drug insurancce or public sources such as Medicaid
Have income not more than 400% of the Federal Poverty Level for Hawai‘i ($47,840 per year for a single person in 2008)
Be enrolled in the case management program of one of the agencies funded by the state to provide HIV Case Management.

How does someone apply for HDAP? Applications for HDAP are handled through agencies that partner with the Department of Health to provide HIV Case Management. The case management agency is required to maintain documentation to support eligibility, including documentation of residence, income, assets, and insurance. Clients receiving HDAP services must be recertified through the case management agency every six months to maintain eligibility in HDAP.

[back to top]

Hawai‘i Insurance Continuation Program (H-COBRA)

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.

COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end.

H-COBRA is a Hawai‘i program specifically for people with HIV. H-COBRA can pay premiums to continue health insurance for people who are COBRA eligible but cannot afford the cost of the premium.

In some situations, H-COBRA can pay premiums for individuals who are no longer eligible for group coverage (including COBRA), but who are eligible to convert from group coverage to an individual "HIPAA conversion plan" under the provisions of the Health Insurance Portability and Accountability Act (HIPAA). Note that H-COBRA cannot provide premium payments for the many HIPAA conversion plans that lack prescription drug coverage.

Who is eligible for H-COBRA? To be eligible for H-COBRA, an individual must:

Live in Hawai‘i
Be HIV positive
Be eligible for insurance continuation under federal COBRA guidelines (or for conversion to an individual plan under the HIPAA guidelines)
Have income below 300% of the Federal Poverty Level for Hawai‘i ($35,880 per year for a single person in 2008)

How does someone apply for H-COBRA? Contact the HIV Case Management agency on your island for assitance applying for H-COBRA.

[back to top]

Confidentiality Policy

HSPAMM, HDAP and H-COBRA records are always kept confidential. The HSPAMM program is anonymous and the program does not receive any identifying information. HDAP or H-COBRA need participant’s identifying information in order to provide prescription drugs and in order to pay health insurance premiums. These records are protects by from release by:

The staff of HSPAMM, HDAP and H-COBRA will not disclose protected information without an individual’s written consent. State law prohibits unauthorized disclosure of protected information by staff even after termination of their employment.

[back to top]

Last update: 05/07/2008