Massachusetts Health Officials Ask State Legislature for Additional ADAP Funding; Program Facing $6.6M Deficit

Massachusetts Department of Public Health Commissioner Christine Ferguson on Thursday sent a letter to the state Legislature requesting an additional $4.2 million for the state's AIDS Drug Assistance Program to avoid a projected $6.6 million budget deficit for the fiscal year that begins July 1, the Boston Globe reports (Smith, Boston Globe, 5/14). ADAPs -- which are funded with both state and federal money -- provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals. According to the most recent "ADAP Watch" from the National Alliance of State and Territorial AIDS Directors, 13 states as of last month had implemented waiting lists or access restrictions on their ADAPs (Kaiser Daily HIV/AIDS Report, 4/15). The projected deficit for Massachusetts' ADAP -- which could cause "radical restrictions, including waiting lists and reduced drug benefits" -- has arisen due to an "unprecedented surge in demand," according to the Globe. In the letter to state Sen. Richard Moore (D), chair of the Joint Committee on Health Care, Ferguson said that ADAP restrictions could "risk serious health outcomes, including death, and will have an effect on the overall transmission rates of HIV" in Massachusetts. Moore aide Brian Cournoyer said that Moore intends to introduce an amendment to state Senate budget legislation that would increase ADAP funding by $4 million.

Maxed Out
The Massachusetts ADAP program either covers the full cost of medications for qualified HIV-positive people -- which can exceed $15,000 annually -- or pays for participants' health insurance premiums or drug copayments, the Globe reports. Enrollment in Massachusetts' ADAP has increased by more than 70% in the past year because many HIV/AIDS patients were shifted to ADAP from MassHealth/> -- the state's Medicaid program -- after the Legislature in 2003 "tightened" the program's qualification rules for HIV-positive patients, according to the Globe. The state projects that ADAP enrollment will increase from the current 3,200 beneficiaries to about 4,000 by the end of the next fiscal year, according to the Globe. From August 2003 to March 2004, there has been a 28% increase in patients receiving full drug coverage, which is "by far" the costliest element of ADAP, according to the Globe. Spending on the program has increased from approximately $1 million per month to $1.4 million in March. "We are very concerned about this sudden and dramatic increase in utilization," Julie Marston, executive director of Community Research Initiative of New England -- the private organization that runs the state's ADAP -- said, adding, "The reason that we're so worried about this is because we've already exhausted all ways of maximizing efficiency in this program" (Boston Globe, 5/14).

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