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Action Alert: Ohioans Living With HIV/AIDS Need Our Help!!!

By Kevin Maloney

January 16, 2012

As goes Ohio, so could the nation. The Ohio Health Department is putting up a strong fight to lower the federal poverty limit from its height of 500% in July 2010, lowered to 300% at that time, to now have the ability to implement a potential income eligibility change to as low as 100% FPL at anytime with no notice to anyone with a stroke of pen. If that rule had gone into effect, it would mean in order to qualify for the AIDS Drug Assistance Program a single individual cannot make more than $10,890 a year. Further, ODH could implement medical criteria one must also meet. Those given the highest priority will be PLWHA with CD4 counts lower than 201. The medical criteria make no mention of an important aspect of HIV care: viral load.

Back in December 2011, three Ohio HIV-positive advocates with the assistance of the AIDS Healthcare Foundation won an injunction to these proposed rule changes in the Franklin County, Ohio Court of Common Pleas, resetting the FPL to 300%. ODH had proposed one set of rules, had a hearing, and then changed the rules to the above without telling anyone. The judge had ordered ODH to go back to the drawing board ... and they did. The end result is the terrible rules listed above.

If the Ohio Health Department gets their way and decides to lower the income limit to 100% FPL, nearly 2,600 of Ohio's PLWHA will be forced off of ADAP (half of the program), and countless others who will become newly infected will have no access to the medicine they need. PLWHA no matter what their socioeconomic background should be privy to medicine that will keep them alive and healthy.

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Is this not the reason behind these medications? With today's medicine PLWHA can lead long, productive lives; they are at less risk of developing an opportunistic infection, and in 2011 a ground-breaking study came out that stated those on antiretroviral therapy are 96 percent less likely to pass the virus to their partner.

We must not let Ohio implement these rules on the backs of the poor and vulnerable, especially those living with a potentially life-threatening disease such as HIV/AIDS. After 30 years of this epidemic, we must continue in our efforts to fight for all PLWHA!

How you can help:

Anyone from around the United States can send an email to HCS@odh.ohio.gov emphasizing your concern of these proposed changes. In the subject line use: Rule 3701-44-03.

Click to see the Medical Rule Criteria proposed.

Click to see the proposed changes to financial eligibility.

Send Kevin an email.

Get e-mail notifications every time Kevin's blog is updated.

See Also
2014 National ADAP Monitoring Project Annual Report (PDF)
ADAP Waiting List Update: 35 People in 1 State as of July 23
More Viewpoints on U.S. ADAP Funding

Reader Comments:

Comment by: Michael Para, MD (Columbus, Ohio) Mon., Jan. 23, 2012 at 9:30 pm EST
You have completely missed the point with the Ohio law. Every HIV clinician and every NGO in the state was in support of this change. The law made the 100 % FPL the FLOOR which does not exist in the current law. The medical criteria are critical if there is a waiting list, rather than first on the waiting list the first to receive medications.
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Replies to this comment:
Comment by: just some HIV patient (Cleveland) Wed., Jan. 25, 2012 at 2:26 am EST
It seems probable to me that another long waitlist is inevitable. When that happens, I can only assume that Ohio will decide to cope with this as directed, first by pegging eligibility to this new "FLOOR" and then by utilizing cd4 prioritization. The effect will be that most who are employed in any capacity will be thrown off ADAP eligibility and those who remain will find themselves waiting for their cd4 counts to drop below 200. The implications for public and individual health are catastrophic.

Effectively, the working classes and poor will be forced into poverty along with the unemployed, and everyone will have to wait for an AIDS diagnosis before they can begin treatment. Further, my understanding is that many drug companies peg their patient assistance programs to ADAP eligibility, thus forcing many short term unemployed into a cycle of degraded health that they would not otherwise face, were it not for these new standards.

I understand the appeal of having "floors" and prioritizations. The people who will most benefit from them are my friends and your patients. Believe me, it has been hard for me to watch what they've gone through. I know it has been hard for you to watch this happen to your patients. I also live in a world in which those "floors" and prioritizations will become de-facto standards, as there is apparently an absence of appropriate funding for this program.

Inevitably, without treatment, we will all progress to AIDS. Therefore, this program doesn't cut any costs, it merely defers them. By compromising our health, it probably magnifies them too. I find this law sets the floor, and the prioritizations, WAY too low for individual and public health. If what you say is true and "every HIV clinician and NGO in the state" supports this, we are all right to be deeply troubled. I thank Kevin for bringing this to my attention, and urge everyone to continue their opposition to this campaign.
Comment by: HIV WNY patient (Buffalo, NY) Sun., Feb. 19, 2012 at 7:58 am EST
Every sick patient deserves treatment. Who can afford 25,000$ a year for medicine? There will be thousands of sick people infecting each other and more. I'm appalled and outraged. What year is this anyway?

[Moderator's note: This comment was modified to remove a personal flame. Please, when you leave a comment, be sure it focuses on the issue at hand, not on putting down others! Else your comment may be edited or deleted.]


Comment by: Anonymous II Thu., Jan. 19, 2012 at 4:19 pm EST
PLWHA = People Living with HIV and AIDS
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Comment by: Anonymous Wed., Jan. 18, 2012 at 11:11 am EST
wow. It sounds to me like they are trying to drive people with hiv/aids out of Ohio. This is about impossible. Please explain what PLWHA stands for. Sorry.
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Kevin Maloney

Kevin Maloney

Random things about me: I am kind, caring, respectful and wanting to make a difference/impact in the World. I've been to Australia, New Zealand and 13 countries in Europe, and have traveled and lived all over the United States. I have a Bachelor's degree in Health Services Management and will be working towards my Master's In Public Health. I am an uncle of two of the MOST adorable girls in the World, and have one brother. I am a Momma's boy, and it is hard to see my mother's health in such a deteriorated state -- she has severe COPD (from 40 years of smoking). In March 2010 I was told that I have HIV and a month later, with follow-up labs, was then told I also acquired hepatitis C (not through IV drug use). I aspire to great things. Stay tuned.

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