June 28, 2011
Texas officials said Friday they are exploring various responses to a projected $19.2 million shortfall in the state AIDS Drug Assistance Program. One option would be closing ADAP to new patients, but no decisions have been made, Dr. Adolfo Valadez, assistant commissioner of the Department of State Health Services (DSHS), said at the meeting of the Texas HIV Medication Advisory Committee.
Other steps under consideration include asking drug companies for discounts or dropping coverage for more expensive drugs. A subcommittee to be formed after July 4 will be tasked with developing cost-containment suggestions.
The shortfall is expected to hit during the second year of the two-year budget, or sometime after Sept. 1, 2012.
Florida, facing a similar situation, made some "very draconian cuts that wouldn't pass muster in Kenya," said Dr. Philip Keiser, chair of the advisory committee and an infectious-disease specialist at the University of Texas Medical Branch-Galveston. "If we do that, I promise, there will be people who will die from this."
It will cost Texas ADAP $97 million to serve its 15,249 patients this year.
Gov. Rick Perry signed a budget provision that directs DSHS to request more money from the state Medicaid program if ADAP runs out. That budget, however, left a projected $4.8 billion shortfall in Medicaid that the next Legislature will face beginning in January 2013.
Patient-advocates are worried. Austin's David Powell Clinic and 19 other CommUnityCare clinics in Travis County will soon begin routinely testing patients for HIV, an effort that is projected to diagnose 400 people a year. But Lynda Blakeslee, DPC's grants manager, asked the advisory committee, "Why would I want to participate in that if I can't offer them medication?"