January 21, 2010
Nine U.S. states now have waiting lists for their AIDS Drug Assistance Programs (ADAPs), state-funded programs that help low-income HIVers pay for the medications they need. As a growing number of people are forced to wait for ADAP access, many of them need to seek out other programs that can help cover medication costs in the meantime. Bridge the Gap is one such program.
"There's a problem here. There's a need, and the demand is not being met by the federal dollars that are allocated," says Gregory Edwards, Ed.D. He's the executive director of the Flowers Heritage Foundation, the nonprofit group that runs Bridge the Gap. Bridge the Gap is designed to raise funds and distribute them to people on ADAP wait lists for them to use for buying HIV-related medications.
Bridge the Gap was founded in 2006 and initially served 13 people in Montana. The Flowers Heritage Foundation was created by Ramsell Holding Corporation, a pharmacy benefits management company. "Upon learning that the state of Montana had people going on a wait list [in 2006], they thought it simply made sense to give back to the larger and broader community in this fashion, so they created the Bridge the Gap program," Dr. Edwards says.
Since 2006, the amount of people on waiting lists nationally has fluctuated, and Bridge the Gap has attempted to adjust to meet those needs. Currently, Bridge the Gap funds HIV-related medications for 34 people in Montana, at a cost of between $10,000 and $12,000 per person per year, Dr. Edwards says. Now that more states are creating waiting lists, the program is hoping to get involved with additional states.
The decision of whether to expand to include more states is not up to Bridge the Gap, according to Dr. Edwards. He says it is up to each state's ADAP director to decide to participate and enroll their wait-listed people. "We could not take any initiative to decide who to fund, or not fund. That's why the impetus is on the state directors to enroll in the program," Dr. Edwards explains.
Once a state has agreed to use the program, that state's ADAP director can access a live, Web-based system and enroll people in Bridge the Gap, Dr. Edwards says. "As funds become available, whoever's at the top of the list is immediately funded," he explains. The list is first-come, first-served: The people who were enrolled the longest ago are at the top of the list, Dr. Edwards says. Bridge the Gap funds go directly to the person's local pharmacy and cover all medications listed on the state's ADAP formulary, Dr. Edwards says. The entire process is completely anonymous: No one at Bridge the Gap even knows its enrollees names or locations, Dr. Edwards notes.
"What makes our program particularly unique at the Flowers Heritage Foundation is that Ramsell [the parent company] also covers all of our administrative costs, 100 percent," says Dr. Edwards. "One hundred percent of all dollars donated go directly to our patients and charitable causes and programs. So 100 percent of the funds people donate for the Bridge the Gap go to fund medication for people living with HIV and AIDS in the U.S."
Until now, virtually all of Bridge the Gap's funding has been provided by Ramsell, but the program has begun seeking out additional means of support. Late last year, it partnered with the National Minority AIDS Council (NMAC) to raise awareness of the program -- and to reach out for donations. "To date, some 95 percent of the funds have come from Ramsell," says Dr. Edwards. "We've also received a huge grant from the MAC AIDS Foundation. The other funds have come from individual donors."
It's those individual donors that Dr. Edwards hopes will become more active. "We know that different people support different organizations for different reasons," he explains. That's why Bridge the Gap is partnering with a variety of groups, including POZ magazine, the National Association of People With AIDS and the Black AIDS Institute, as well as NMAC. "We're trying to create an 'Obama-esque' system of getting people to donate five, 10, 20 dollars each," Dr. Edwards says. (People can use PayPal to donate to the Flowers Heritage Foundation online.) For now, however, the program remains funded primarily by Ramsell.
Meanwhile, only Montana officially is enrolled with Bridge the Gap, although Utah and Tennessee are both considering it, according to Dr. Edwards. Late last year, the National Alliance of State and Territorial AIDS Directors (NASTAD) sent a memo to all states with ADAP waiting lists, letting them know about Bridge the Gap as an option. Dr. Edwards says NASTAD is planning to send another memo soon, this time to every state.
As ADAP waiting lists grow in more U.S. states, the need for programs like Bridge the Gap grows with them. "We're still waiting for the word to get out about Bridge the Gap, and to enroll other states," says Dr. Edwards. "It's really up to the state ADAP directors to take the initiative."