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Loss of Funding, Increase in Participants Likely to Cause Kentucky ADAP to Implement Waiting List

December 3, 2008

Kentucky's AIDS Drug Assistance Program -- which provides medications to low-income, uninsured and underinsured HIV-positive people -- has lost a significant portion of its federal and state funding over the past three years and may be forced to reinstate a waiting list by April, state health officials said Monday, the Lexington Herald-Leader reports.

According to Sigga Jagne, branch manager for the program with the state Cabinet for Health and Family Services, an increase in the number of patients who have applied for assistance has coincided with the drop in funding. Jagne said, "We are seeing 50 new patients a month," which is up from monthly figures of 35 in 2007 and 23 in 2006. However, federal funding decreased from $4.6 million in 2005 to $4.3 million in 2008; antiretrovirals can cost between $2,000 and $10,000 a month. Deborah Wade, program director for the WINGS Clinic at the University of Louisville, said that in 2005, "Kentucky had the longest waiting list of all states for the drug program," adding that 30% of her 1,100 clients do not have insurance and are in need of the program's assistance.

According to the Herald-Leader, a waiting list was eliminated in 2006 as the program became more efficient and the state Legislature appropriated money to the program, beginning in 2004. However, no money for the program was appropriated for this fiscal year. Jagne said Kentucky already is preparing a waiting list and that social workers who work with HIV-positive people are getting ready to fill out applications for individual drug companies' no-cost or reduced-cost programs until additional funding can be found. Kraig Humbaugh, director of the Division of Epidemiology and Health Planning for CHFS, said the agency is looking at all options but, with a state facing a deficit of more than $450 million, it has to be pragmatic.

Humbaugh said that two other states already have implemented waiting lists and that six others have put some type of cap on antiretrovirals covered or the number of people who can receive services. The Herald-Leader reports that HIV/AIDS advocates argue it is more cost-effective for states and the federal government to pay for antiretrovirals than to wait until someone becomes seriously ill. Wade said, "People who don't get their medicines get really, really sick. That means that they are admitted to the emergency rooms and eventually moved to intensive care. They stay longer. They can't work ... and taxpayers are going to have to pay for that." According to advocates, life expectancy for HIV-positive people nationwide and in Kentucky has greatly improved, largely because of access to antiretrovirals (Musgrave, Lexington Herald-Leader, 12/2).

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