California: State's AIDS Drug Program Largely Safe From Cuts

California's AIDS Drug Assistance Program (ADAP) should be mostly spared from $12.4 billion in state budget cuts proposed to help plug a $19.1 billion deficit, advocates say. However, utilization controls proposed for Medi-Cal remain a concern.

There is no more "low-hanging fruit," Gov. Arnold Schwarzenegger said on May 14 as he released a revised budget proposal for 2010-11. "We have to take the ladder from the tree and shake the whole tree."

The state ADAP would receive a $32.7 million adjustment, mostly related to administration, said Anne Donnelly, director of health care policy for Project Inform. "It shouldn't affect ADAP services," though the budget would eliminate support for county jail inmates.

Medi-Cal would lose $523 million, and the program could eliminate coverage of some over-the-counter drugs, such as aspirin or cold medicine. "That could seem minor, except we're talking about people who really have no money to support them," Donnelly said.

Medi-Cal prescriptions would be limited to six per month, except for "life-saving drugs" -- a category as yet undefined, Donnelly said. The proposal also would limit the number of clinician or physician visits to 10 each year. Emergency department visits could require a $50 co-pay.

The ADAP news is "very, very good," said Dr. Michelle Roland, chief of the state Office of AIDS. ADAP needed less money in part because of national health care reform and an increase in state-distributed federal Ryan White Part B funds, she said. However, "we never really know what we're going to be left with until we have a signed and enacted budget."

The Assembly budget subcommittee has voted to restore funds for "a number of items," including HIV testing and prevention, that Schwarzenegger cut by line-item veto last summer, Roland said. However, Roland said it is unknown whether the restoration of funds will stand. The $52.1 million the governor slashed from AIDS programs in 2009 was in addition to more than $30 million already cut by lawmakers.

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