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Policy & Politics
California Senate Budget Subcommittee Rejects ADAP Enrollment Caps, Waiting List

March 9, 2004

The California Senate Subcommittee on Health and Human Services on Monday rejected a proposal by Gov. Arnold Schwarzenegger (R) to cap enrollment and create a waiting list for the state's AIDS Drug Assistance Program, the Los Angeles Times reports (Ingram, Los Angeles Times, 3/9). The plan is outlined in the governor's fiscal year 2004-2005 budget proposal, which also includes a 2% cut in funding for state HIV/AIDS prevention and treatment programs. ADAP -- which is financed with both state and federal funds -- provides HIV treatment to low-income, uninsured and underinsured HIV-positive individuals. Schwarzenegger's budget would have capped enrollment in the program at the current level of 23,900 enrollees. If implemented, the cap would have prevented more than 1,400 HIV-positive people in California from accessing antiretroviral drugs and existing enrollees would have faced reduced benefits. According to AIDS advocates, lawmakers need to add $25 million to ADAP's proposed $207 million budget to avoid waiting lists and maintain the current list of available drugs (Kaiser Daily HIV/AIDS Report, 3/8).

Higher Long Term Costs
Speaking to a crowd of AIDS advocates who demonstrated against the cuts at the state capitol in Sacramento on Monday, state Sen. Wes Chesbro (D), who chairs the subcommittee, said that limiting the number of HIV/AIDS patients in ADAP would cost the state more money in the long term, according to the San Francisco Chronicle. "It's clear this would be sending people ... to a lifetime of disability and eventually death," Chesbro said, adding, "Not only is that not humane, it will cost the state money in the long run in hospitalization costs" (Gledhill, San Francisco Chronicle, 3/9). Subcommittee members said that the proposed cuts and the enrollment cap could be avoided by using $20 million in drug rebates that were found by subcommittee staff in an "apparently neglected" state Department of Health Services account, according to the Times. The $20 million would "more than offset" ADAP reductions, according to subcommittee members (Los Angeles Times, 3/9). The enrollment cap would have saved the state $550,000, according to the Chronicle (San Francisco Chronicle, 3/9). Chesbro said that before any ADAP enrollment caps or waiting lists are instituted, the state Senate would "squeeze maximum 'efficiencies and cost-containments'" from the health department, according to the Times (Los Angeles Times, 3/9). Chesbro said that the state could save $800,000 by making improvements in the program, such as allowing automatic refills of medications for up to six months, according to the Chronicle.

Reaction
AIDS advocates welcomed the subcommittee's rejection of the enrollment cap and waiting list, according to the Chronicle. "We're extremely gratified they ultimately understood it was a matter of life or death," Fred Dillon, public policy director of the San Francisco AIDS Foundation, said, adding, "We certainly [are] willing to work with the Legislature and the governor's office to come up with solutions. We understand we are faced with a terrible fiscal crisis in California." H.D. Palmer, spokesperson for the state Department of Finance, said that the governor proposed the cap because it would not take benefits away from current recipients, the Chronicle reports. "If the Legislature chooses to reject [the cap and waiting list], the simple math is that they are going to have to come up with like amount of savings," Palmer said (San Francisco Chronicle, 3/9).

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Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2004 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.




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