Single Source Procurement: Tele-Medicine for Expanded Access to PrEP

Pursuant to New York State Finance Law § 163.10(b), The New York State Department of Health is presenting the following summary of relevant circumstances, and material and substantial reasons why a competitive procurement was not feasible.

Tele-medicine is the delivery of clinical health care services by means of real time two-way electronic audio visual communications, which facilitate care management and self-management of a patient's' health care while the health provider is at a distant site. This model will provide access to PrEP to individuals at high risk of becoming infected with HIV who live in areas where local services are not available. Tele-medicine patients visit with a provider based in a health care setting and, in addition to clinical consults, gain access to additional support services that include treatment adherence counseling, risk reduction assessment and counseling.

Communities across New York State with high prevalence rates of new infections and/or limited access to PrEP providers will be identified. The contractor for this service will work with community providers to develop tele-medicine contracts so health care and support services are provided in those locations. Success in expanding PrEP to new geographic areas requires community engagement and education specific to each new market. Over the course of this 4 year contract amendment, the proposed model will expand PrEP care to four upstate New York communities.

This pilot program will establish a tele-medicine model for expanding access to pre-exposure prophylaxis (PrEP) for at-risk individuals in NYS who are geographically handicapped when seeking a PrEP prescriber. The 2015 Blueprint for achieving the goal set forth by Governor Cuomo to end the epidemic in New York State by the end of 2020 contains Recommendation-#22 which points out the need for "access to care for residents of rural, suburban and other areas of the state….New York is a large state impacted by varied levels of care access and varied formal care structures. As a result of this varied access, the effective use of telehealth, telemedicine, digital and electronic care coordination models should be instituted among care and support service providers".

Telemedicine is a relatively new field and Trillium Health is the only NYS HIV provider that is delivering HIV treatment via the tele-medicine model. Currently, they provide comprehensive specialty care in the areas of HIV, HIV prevention, and Hepatitis C to patients of Fingerlakes Community Health in Geneva, New York using the Tele-Health program.

Trillium Health is also the leading provider of PrEP in upstate New York, with over 120 HIV-negative individuals currently utilizing PrEP as HIV prevention. They have provided PrEP services to over 160 individuals since 2012.

Trillium has demonstrated their ability to provide HIV services to individuals geographically isolated from their physical medical site via telemedicine in Geneva, NY. This experience combined with the success at their Rochester facility promoting and providing PrEP services is truly ideal for implementing this model in upstate NY. Their fully operational HIV tele-medicine program, tested protocols and procedures and experienced staff ensures a prompt startup of services.

These three specific criteria identify Trillium Health as being uniquely qualified for this project. No other organizations can meet these essential requirements at this time.

Procurement / Program Name Tele-Medicine for Expanded Access to PrEP
Contractor Name(s) Trillium Health
Contract Period 4/1/2015-3/31/2019
Contract Number(s) C029981