November 19, 2012
As of November 15, 2012, there are 87 individuals on ADAP waiting lists in five (5) states. North Carolina eliminated their waiting list as of November 2 and Georgia and Florida are currently enrolling new clients into their programs and do not have any individuals on their waiting lists. However, they remain listed as they have not formally closed their waiting lists. Idaho has eight individuals on their waiting list which was reestablished in October. Louisiana and South Dakota have added 28 and five individuals, respectively, to their waiting lists.
The receipt of $75 million in ADAP Emergency Relief Funding (ERF) has allowed many states to make significant reductions in their waiting list numbers, but the potential for new waiting lists developing this fiscal year (ending March 31, 2013) continues. Two states currently report having capped enrollments, and another anticipates opening a wait list in 2013. 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.
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 Active Waiting Lists|
(87 Individuals in 5 States*, as of November 15, 2012)
|State||Number of Individuals on ADAP Waiting List||Percent of the Total ADAP Waiting List||Increase/Decrease From Previous Reporting Period||Date Waiting List Began|
|South Dakota||21||24%||5||August 2012|
* As a result of FY2012 ADAP emergency funding, Alabama, Florida, Georgia, Idaho, Louisiana, Montana, Nebraska, North Carolina, and Virginia were able to reduce the overall number of individuals on their waiting lists.
|ADAPs With Capped Enrollment (as of November 15, 2012)|
|Utah||450 direct medication clients, 100 insurance clients|
Since September 2009, six ADAPs previously lowered their financial eligibility as part of their cost-containment plans. Illinois, North Dakota, Ohio and South Carolina lowered their eligibility level to 300 % FPL. Utah lowered its eligibility level to 250% FPL. Arkansas lowered its eligibility level to 200% FPL. Previously, income eligibility for the states noted above was 400% FPL or higher. As a result of these measures, a total of 445 individuals in three states (Arkansas - 99, Ohio - 257, and Utah 89) were disenrolled. Illinois, North Dakota, and South Carolina grandfathered clients that were previously eligible based on their income level into their programs. No other ADAPs currently report anticipating further changes to their financial eligibility.
Alabama: reduced formulary
Alaska: reduced formulary
Arkansas: reduced formulary
Florida: reduced formulary, transitioned 5,403 clients to Welvista from February 15 to March 31, 2011
Georgia: reduced formulary, implemented medical criteria, participating in the Alternative Method Demonstration Project
Illinois: reduced formulary, instituted monthly expenditure cap ($2,000 per client per month)
Kentucky: reduced formulary
Louisiana: discontinued reimbursement of laboratory assays
Nebraska: reduced formulary
North Carolina: reduced formulary
North Dakota: capped enrollment, instituted annual expenditure cap
Puerto Rico: reduced formulary
South Dakota: annual expenditure cap ($10,500)
Tennessee: reduced formulary
Utah: reduced formulary
Virginia: restricted eligibility criteria
Washington: instituted client cost sharing, reduced formulary, only paying insurance premiums for clients currently on antiretrovirals
Wyoming: reduced formulary, instituted client cost sharing
Maine: reduced formulary
Montana: waiting list