I have blogged about our team member’s journey to TriYoung but never told my story…
Hi, I am Lisa Fuentes, the Business Development and Data Analyst Specialist at TriYoung, Inc. and my journey to TriYoung started in a completely different field.
I started my career as a Pharmacy Technician. In 2002, I began working with people living with HIV/AIDS at a Ryan White Clinic. I helped facilitate “Club MedBox” which was a lunch event where we helped patients fill their medication boxes and often had guest speakers. This was all to ensure our patients stayed adherent to their antiretroviral therapy medication regimen. In this role, I also helped patients enroll in the AIDS Drug Assistance Program (ADAP) or apply for pharmaceutical manufacturer assistance programs.
While enrolling the patients, in ADAP, I would often get frustrated that they did not meet income criteria when they could barely afford food. Another area that I thought caused undue stress was making clients fill out a different application depending on the renewal type. If a client accidently filled the wrong application out, they had to recomplete a new one. In addition, the clients had to carry their eligibility documentation with them to all their appointments to prove they were Ryan White eligible. I vowed that if I ever became the ADAP Program Manager, I would fight for change.
In 2006, I was presented with an opportunity to apply for the ADAP Coordinator position. During my tenure with the ADAP program, we combined the applications so there was only one application. We moved all the ADAP files from paper to electronic. We worked with Julie Young at TriYoung to transition ADAP to CAREWare.
In 2012, I was asked to step in as the Ryan White Part B Program Manager as they were moving the current program manager into a new role. This was the ADAP Program Managers supervisor and my opportunity to make even more positive change. The program began collecting rebate income and we were able to raise the Federal Poverty Level (FPL) for the Ryan White program from 300% to 400% FPL. More people now qualified for life saving medication and services. We then implemented a Medical Benefits Manager (MBM) and began enrolling clients in insurance to help cover the cost of care. Julie Young from TriYoung helped us develop a web application that allowed the MBM to view eligibility before paying premiums or medical bills. The system even allowed the MBM user to print a check run for accounting to send to the insurance companies.
In 2013, we were tasked with the implementation of the Affordable Care Act and ensuring Ryan White was payor of last resort. I hired an excellent candidate with Medicaid experience to fill the ADAP Program Manager position. Since we shared clients with the County, we needed a way to track what insurance bucket each ADAP client fell in to ensure Ryan White was payer of last resort. Again, we worked with Julie Young at TriYoung. She developed a tool that allowed us to track the enrollment progress of each client so we were not supplanting enrollment efforts and could all have real time progress updates. The system and initial enrollment were a success.
In 2014, we began a statewide group to develop a statewide centralized eligibility system that allowed Ryan White service providers to verify eligibility before providing a service. This also meant the client no longer had to carry their proof of eligibility everywhere to receive services. This was the birth of the system we now call the Ryan White Integrated Statewide Eligibility (RWISE). In addition, my Ryan White fiscal team worked with Julie Young to implement the Grant Management System (GMS). This is a web-based interface that allows for grant set-up, allocations/reallocations, provider budgets, fiscal reports, eligibility analysis review of services billed, task orders and contract management.
I resigned from my position as Ryan White Program Manager in 2015 prior to the RWISE implementation to return to my career in pharmacy and reduce my stress levels. After leaving my role, I missed working with the community I served for so long. So, when I received a call from Julie Young in 2017 asking if I would be willing to speak to other Ryan White Programs about the wonderful systems we implemented in Arizona, I did not hesitate to accept. I have now been with TriYoung for over five and a half years. My role has allowed me to work with Ryan White Programs throughout the United States of America to help them streamline their processes, implement our web applications, and save time so they can focus on the clients they serve. I could have never imagined my career would lead me here, but this is exactly where I was meant to be.