1,431 People Now on ADAP Waiting Lists in 11 States, Report Says

As of June 10, 2010, there were 1,431 individuals on AIDS Drug Assistance Program (ADAP) waiting lists in eleven states. This is a 116 percent increase from the 662 individuals on the March 2010 ADAP Watch. Twelve ADAPs, four with current waiting lists, have instituted additional cost-containment measures since April 1, 2009. In addition, seven ADAPs, including two with current waiting lists, are considering implementing new or additional cost-containment measures by the end of March 2011. States that have instituted cost containment measures and those considering them, in addition to implementing waiting lists, are reducing program eligibility, capping enrollment, reducing the number of drugs on the formulary and cutting other services, all of which impact access to life saving HIV medications for medically vulnerable individuals.

With continuing cuts in state funding, growing client demand for access to ADAP services and minimal federal increases, it is paramount that emergency federal resources be made available to stave off the crisis most ADAP programs and the clients they serve are facing. ADAPs received an increase of $20 million in federal funding in FY2010, however, this falls far short of what is necessary for ADAPs to clear current waiting lists and maintain current and newly eligible clients. NASTAD and other community organizations are appealing for an additional $126 million in FY2010 emergency federal funding to allow states to continue their programs and clear waiting lists without imposing further access restrictions for people living with HIV/AIDS who need ADAP services. ADAPs continue to operate efficient and cost effective programs and drug distribution systems as well as securing the lowest prices on HIV antiretroviral possible. These savings, though significant, do not preclude the need for additional federal resources to patch the growing gaps in access.

For many states, the program's viability depends on federal funding awards and state general revenue support for the next state fiscal year (in most states this begins on July 1, 2010). From FY2008 to 2009, ADAPs nationally experienced an average monthly growth of 1,271 clients. This is an unprecedented increase of 80 percent from FY2008 when ADAPs experienced an average monthly growth of 706 clients.

ADAPs With Current or Anticipated Cost-Containment Measures, Including Waiting Lists, June 2010

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The following ADAPs reported cost containment strategies. Other ADAPs may need to consider changes but due to unfinished state budget processes, political factors and other considerations, have not reported them.

ADAPs With Waiting Lists (1,431 Individuals, as of June 10, 2010)*

Florida: 113 individuals
Hawaii: 7 individuals
Idaho: 25 individuals
Iowa: 91 individuals
Kentucky: 177 individuals
Montana: 18 individuals
North Carolina: 710 individuals
South Carolina: 145 individuals
South Dakota: 21 individuals
Utah: 104 individuals
Wyoming: 20 individuals

ADAPs With Other Cost-Containment Strategies (Instituted Since April 1, 2009)

Arizona: reduced formulary
Arkansas: reduced formulary, lowered financial eligibility to 200% of FPL
Colorado: reduced formulary
Illinois: reduced formulary
Iowa: reduced formulary
Kentucky: reduced formulary
Louisiana: capped enrollment, discontinued reimbursement of laboratory assays
Missouri: reduced formulary
North Carolina: reduced formulary
North Dakota: capped enrollment, cap on Fuzeon, lowered financial eligibility to 300% FPL
Utah: reduced formulary, lowered financial eligibility to 250% FPL
Washington: client cost sharing, reduced formulary (for uninsured clients only)

ADAPs Considering New/Additional Cost-Containment Measures (Before March 31, 2011**)

Arizona: waiting list
California: proposed elimination of ADAP services in city and county jails
Florida: reduced formulary, lowered financial eligibility
Illinois: reduced formulary, lowered financial eligibility, monthly expenditure cap
Ohio: reduced formulary, lowered financial eligibility, capped enrollment, client cost sharing, annual and monthly expenditure caps
Oregon: reduced formulary, client cost sharing, annual expenditure cap
Wyoming: reduced formulary

* Montana, South Dakota, Utah, and Wyoming waiting list numbers are reported as of June 2, 2010
** March 31, 2011 is the end of ADAP FY2010. ADAP fiscal years begin April 1 and end March 31.