ADAP Waiting List Update: 113 People in 3 States as of May 29

As of May 29, 2013, there are 113 individuals on ADAP waiting lists in three states. Alabama currently has 96 people on their waiting list which opened in April. In the last month, South Dakota remained steady with 17 individuals. Idaho experienced a decrease of 14 individuals, clearing their current waiting list, but will continue to add new individuals to the wait list as applications are received.

In FY2013, ADAP was funded at $886 million, a cut of $47 million, due to sequestration. The funding level also did not include $35 million in emergency relief funding (ERF) that President Obama announced on World AIDS Day 2011 for FY2012. (This ERF funding was awarded to 15 states and territories in last year.) Last week, NASTAD learned that the Office of Management and Budget (OMB) sent a letter to Congress authorizing transfers of $35 million to ADAP to continue the ERF. Unlike the FY2012 ERF funding, a portion of this year's $35 million was redirected from other parts of Ryan White and HIV prevention. The remaining funding came from other sources. The HRSA operating plan which details funding amounts for all programs at the agency can be found here. This transfer does not affect the sequestration cut. HRSA will be sending a funding opportunity announcement for the $35 million in ERF shortly for current and new grantees.

Finally, additional changes to the Ryan White Part B/ADAP formula distribution will take effect for FY2013. These will also likely result in funding shifts for state ADAPs. Only name-based HIV cases reported to CDC will be used in the formula calculations and the hold harmless provision will decrease to 92.5% of states' FY2012 award. Ongoing shifts in the proportion of the nation's living HIV/AIDS cases will occur as well.

HRSA has indicated that final FY2013 notice of grant awards that include these shifts and cuts will be transmitted to states by the end of June. NASTAD anticipates that ADAPs may institute additional cost containment measures once their final awards are received. NASTAD monitors cost containment measures for ADAPs on a weekly basis and currently publishes the ADAP Watch monthly. If waiting lists begin to grow as a result of the above fiscal issues, NASTAD will publish the ADAP Watch more frequently.

Uninsured or underinsured individuals living with HIV who are ineligible for ADAPs can access needed medications using the common patient assistance program (PAP) application form to apply for multiple PAPs. This form can be found on NASTAD's website and the HRSA website. 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.

Please contact Christopher Cannon if you have questions.

ADAPs With Other Cost-Containment Strategies (From April 1, 2012 Through February 6, 2013*)

Enrollment Cap:
Idaho
Indiana
Utah
Wyoming

Expenditure Cap:
Illinois: (monthly)
Kentucky: (annual)
New Mexico: (monthly)
South Dakota: (annual)

Formulary Reduction:
Florida
Illinois
Puerto Rico
Tennessee
Utah
Virgin Island (U.S.)

Other:
Montana: elimination of all support services
Washington: pay insurance premiums only if client is prescribed and taking ARVs

* ADAPs may have other cost-containment strategies that were instituted prior to April 1, 2012.

ADAPs That Eliminated/Modified Cost-Containment Measures (Since December 17, 2012**)

North Carolina (formulary increased)

** ADAPs may have eliminated/modified other cost-containment strategies prior to December 17, 2012.