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ADAP Waiting List Update: 104 People in 5 States as of October 11

October 12, 2012

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As of October 11, 2012, there are 104 individuals on ADAP waiting lists in five (5) states. Virginia eliminated their waiting list as of September 30. Georgia and North Carolina are currently enrolling new clients into their programs at this time and do not have any individuals on their waiting lists. However, they remain listed as they have not formally closed their waiting lists. Louisiana experienced a decrease of 26 individuals, while Florida and South Dakota had increases of 36 and six individuals, respectively, on their waiting lists.

With the recent receipt of the $75 million in ADAP Emergency Relief Funding (ERF) states have made significant reductions in their waiting list numbers, but the potential for new waiting lists developing this fiscal year (ending March 31, 2013) continues. Three states currently report having capped enrollments and several are close to reaching their cap. To see a list of states with access restrictions please visit NASTAD's website.

ADAP enrollment is not static and ADAPs continue to experience increased strain on their programs due to continued enrollment of individuals based on increased efforts to identify new individuals living with HIV or re-engagement of individuals lost to care as part the National HIV/AIDS Strategy. Even with the recent receipt of ERF, some states are not able to eliminate their waiting lists entirely. One state anticipates new cost containment measures and four states report the potential of opening waiting lists by the end of ADAP's FY2012.

House and Senate leaders passed and the President signed a six month Continuing Resolution (CR) that funds the government through March 2013 at the Budget Control Act level. This CR does have a minimal increase of 0.6 percent from FY2012 which may provide a slight increase to overall ADAP funding. However, formula calculations associated with the Ryan White Program may result in fluctuations in ADAP funding for various jurisdictions.

In an effort to streamline and assist clients in need of medications, The Common Patient Assistance Program Application (CPAPA) was launched on September 12 and is now available on the NASTAD website or at http://hab.hrsa.gov/patientassistance/index.html. This single common application allows uninsured individuals living with HIV and/or their providers/caregivers to use one application to apply for multiple patient assistance programs (PAPs) that together provide an entire course of antiretroviral therapy. To see additional information on pharmaceutical company patient assistance or co-payment assistance programs, please visit the Positively Aware website or the Fair Pricing Coalition's website.


ADAPs With Current or Anticipated Cost-Containment Measures, Including Waiting Lists, September 26, 2012
ADAPs With Current or Anticipated Cost-Containment Measures, Including Waiting Lists, September 26, 2012


Waiting List Client Demographics: African Americans and Hispanics represent 49% (32% and 17%, respectively) of clients on current ADAP waiting lists. Combined, Asians, Native Hawaiian/Pacific Islanders and Alaskan Native/American Indians represent approximately 5% of the total ADAP waiting list population. Multi-racial ADAP clients represent 1% of the total ADAP waiting list population. Non-Hispanic whites comprise 41% of clients on ADAP waiting lists. Unknown is currently 1% of the total ADAP waiting list.

Almost two-thirds (67%) of ADAP clients on waiting lists are men. Approximately one third (32%) of ADAP waiting list clients are women. Transgender are only 1% of the ADAP waiting list.


ADAP Waiting List Clients, by Race/Ethnicity, as of September 26, 2012
ADAP Waiting List Clients, by Race/Ethnicity, as of September 26, 2012


ADAP Waiting List Clients, by Gender, as of September 26, 2012
ADAP Waiting List Clients, by Gender, as of September 26, 2012


Access to Medications: Case management services are being provided to ADAP waiting list clients through Part B (5 ADAPs), contracted agencies (2 ADAPs) and other agencies, including other Parts of Ryan White (3 ADAPs).

For clients on ADAP waiting lists who are currently on or in need of medications, all five ADAPs with waiting lists confirm that ADAP waiting list clients are receiving medications through either pharmaceutical company patient assistance programs (PAPs), Welvista, or other mechanisms available within the state.

Waiting List Organization: An ADAP waiting list using a first-come, first-served model is structured to place any individual applying to ADAP on the waiting list in order of receipt of a completed enrollment application and eligibility confirmation. Of the five states with ADAP waiting lists, three utilize a first-come, first-served model for prioritizing clients to join the active client roll.

An ADAP waiting list using a medical criteria model is structured based on a hierarchical criteria typically established by the state based on recommendations from its ADAP Advisory Committee. Of the five states with ADAP waiting lists, two utilize a medical criteria model for prioritizing clients to join the active client roll.

Factors Leading to Implementation of Cost-Containment Measures: ADAPs reported the following factors contributing to consideration or implementation of cost containment measures:

  • Higher demand for ADAP services as a result of increased unemployment (12 ADAPs)
  • Level federal funding awards (11 ADAPs)
  • Increased demand for ADAP services due to comprehensive HIV testing efforts (9 ADAPs)
  • Escalating drug costs (8 ADAPs)
  • State budget decreases (5 ADAPs)
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This article was provided by National Alliance of State and Territorial AIDS Directors. Visit NASTAD's website to find out more about their activities and publications.
 
See Also
2014 National ADAP Monitoring Project Annual Report (PDF)
ADAP Waiting List Update: 35 People in 1 State as of July 23
More on ADAP Restrictions and Waiting Lists

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