MAC Meeting Minutes January 24, 2020

Texas HIV Medication Advisory Committee Meeting

Meeting Minutes
January 24, 2020
1:30 p.m.

Brown Heatly Building, Public Hearing Room
4900 N. Lamar Blvd.
Austin, TX 78751
 

Table 1: Texas HIV Medication Advisory Committee (MAC) member attendance at the Friday, January 24, 2020 meeting

Agenda Item 1: Call Meeting to Order, Welcome and Opening Remarks

Dr. Natalie Vanek, Chair, called the meeting to order at 1:35 pm and welcomed all in attendance. 

Agenda Item 2: Logistical Announcement and Roll Call

Ms. Sallie Allen, Project Manager, Advisory Committee Coordination Office, HHSC reviewed logistical announcements, conducted a roll call and announced a presence of a quorum.

Dr. Vanek provided opening remarks and asked members for introductions. 

Agenda Item 3: Review and approval of the October 18, 2019 meeting minutes

Ms. Allen asked members to review the draft minutes and requested a motion.

Motion: Dr. Natalie Vanek motioned for approval of the October 18, 2019 meeting minutes. Mr. Ray Moore seconded. Ms. Allen called for a voice vote, and the motion passed unanimously with no nays or abstentions to accept the October 18, 2019 minutes.

Agenda Item 4: Commissioners and Legislative Update

Dr. Vanek introduced Ms. Imelda Garcia, and she provided the committee with an update.

Highlights of the update and committee member discussion included:

• The Health Resource and Services Administration (HRSA) conducted a site visit with the Texas HIV Medication Program (THMP), Care Services Group, and a HIV Care Services contractor in Austin. HRSA was very complimentary of work happening in the field and the improvements made by THMP to certify eligible clients. Due to the program’s significant progress, HRSA has requested that DSHS be removed from restricted drawn down. The formal site visit report is anticipated in February.
• The program is making progress on updating program electronic processing systems. Estimated timeline is approximately two years for development and testing.
• Legislature approved a new electronic inventory system for the Pharmacy/Medication Warehouse. Currently in planning phases.

Agenda Item 5: Budget Update

Mr. Felipe Rocha provided the committee with an update on the THMP budget.

Highlights of the discussion and committee member discussion included:

• THMP budget is in the positive. The Program is operating in the black.
• Mr. Felipe Rocha stated he was interested in receiving input from the MAC on the format for presenting the THMP budget. Dr. Natalie Vanek indicated that the Governance and Data Sub-committee will be discussing what data the MAC would like to see presented.
• The Committee discussed the appropriations process and allocated funding.
  • The legislature uses the state agency appropriations requests to build a draft budget and compares them against the entire state budget. The House and Senate have committees to review and hold hearings on the draft appropriations and make changes according to the state’s funding priorities. Once approved by committees, the bill goes to full House and Senate, Comptroller and the Governor for approval.
• The Committee, Mr. Rocha, and Ms. Imelda Garcia discussed the Inventory Spending Plan.
• Mr. Felipe Rocha indicated that client growth was around 6% but has decreased to approximately 3%. However, due to new federal HIV funding initiatives, the program is anticipating 5.5% growth in clients benefiting from medications.

Agenda Item 6: THMP Update

Ms. Rachel Sanor, THMP Manager presented a THMP Summary Fact Sheet for October – December 2019. Highlights of the discussion and committee member discussion included:

• Dr. Susana Lazarte inquired about the medication approval process for clients. Ms. Sanor stated that a Medical Certification Form (MCF) is submitted by medical providers when a client is new to the program or if medications are changed by the provider.
• Data variables requested by Committee included:
  • Transgender data
  • Gender breakdown by age
  • Clients dropped from THMP

Agenda Item 7: Sub-Committee Assignments – Members and Non-members 

Dr. Vanek led the discussion on the sub-committee assignments, members and non-members.

Highlights of the discussion and committee member discussion included:

• Membership of the Governance and Data Sub-Committee.
• Membership of the Formulary Sub-Committee.
• Membership of the Eligibility Sub-Committee.
• Dr. Vanek will reach out to the Committee member who is not currently serving on a sub-committee.

Agenda Item 8: Sub-Committee Reports (Governance/Data, Eligibility and Formulary) 

Ms. Miertschin provided highlights of the Governance and Data subcommittee discussion and committee member discussion included:

• Budget presentation - Dr. Vanek stated the Governance and Data Sub-Committee would discuss what data would be most helpful and how frequently to be presented at MAC meetings.
• Subcommittee membership/recruitment – MAC sub-committee members are appointed by the MAC Chair. All community members serving as subject matter experts must be approved by MAC Chair.
• MAC Membership recruitment/removal – Mr. Rosas requested the MAC look at consumer representation on the MAC. He noted there is no consumer representation from the Houston area. Ms. Sanor explained that when vacancies come up, announcements for applications are released statewide. Membership is filled by looking at vacancies as well as current geographic representation of the MAC.
• Subcommittee goals – Dr. Vanek requested that all sub-committees develop goals for 2020 and report on progress at MAC meetings.

Mr. Rosas provided highlights of the Eligibility subcommittee discussion and committee member discussion included:

• Development of electronic/online THMP eligibility application processing.
• Exploring potential data to assess eligibility processes.

Dr. Vanek provided highlights of the Formulary Sub-Committee discussion and committee member discussion included:

• The sub-committee recently revised the Medical Certification Form to add Top 10 Medications.
• Currently working on addressing long acting medications (distribution, storage, administration, agency training, polices, etc.)

Agenda Item 9: MAC to vote on addition of two medications to the THMP formulary – Livalo and Zypitamag

Dr. Vanek led the discussion regarding the medications Livalo and Zypitamag and asked for a motion to add them to the THMP formulary.

Motion: Ms. Nancy Miertschin motioned to approve the addition of the medications Livalo and Zypitamag to the THMP formulary. Mr. Ray Moore seconded. Ms. Allen called for a voice vote, and the motion carried unanimously with no nays or abstentions to add the medications Livalo and Zypitamag to the THMP formulary

Agenda Item 10: Removal of three medications from the THMP formulary – Elvitegravir, Cobicistat, and Fuzeon

Dr. Vanek led the discussion regarding the medications Elvitegravir, Cobicistat, and Fuzeon and asked for a motion to remove them from the THMP formulary.

Motion: Ms. Nancy Miertschin motioned to remove the medications Elvitegravir, Cobicistat, and Fuzeon, all a standalone medication, from the THMP formulary. Dr. Susana Lazarte seconded. Ms. Allen called for a voice vote, and the motion carried unanimously with no nays or abstentions to remove the medications Elvitegravir, Cobicistat, and Fuzeon, all a standalone medication, from the THMP formulary.

Agenda Item 11: Public Comment

Public comment was received from Mr. Gary Benecke from Dallas. Mr. Benecke expressed appreciation for serving on the Eligibility Sub-Committee and was present to observe a MAC meeting in person.

Agenda Item 12: MAC to vote on January meeting date for 2021

Dr. Vanek led the discussion regarding the meeting date January 2021 and asked for a motion to select one of the proposed dates, January 22 or January 29, 2021.

Motion: Mr. Frank Rosas motioned to approve January 29, 2021. Ms. Nancy Miertschin seconded. Ms. Allen called for a voice vote, and the motion carried unanimously with no nays or abstentions to make January 29, 2021 as their meeting date.

Agenda Item 13: Adjournment

Dr. Vanek thanked the members and the public, and adjourned the meeting at 3:20 pm.

 
Below is the link to the archived video of the January 24, 2020 Texas HIV Medication Advisory Committee meeting. (To view and listen to the entirety of the meeting click on the link below)

January 24, 2020 Texas HIV Medication Advisory Committee meeting