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July ADAP Update: State and Federal Programs Get an A for Effort, but Waiting Lists Keep Growing

By Becky Allen

July 28, 2010

Becky Allen is TheBody.com's site manager.

For what feels like the first time in months, there's good news about U.S. AIDS Drug Assistance Program (ADAP) waiting lists.

North Carolina's ADAP reopened on July 11, for the first time since January. At the beginning of the month, N.C. had 783 people on its waiting list; now, thanks to an influx of $14 million in state funds, that number is down to 182, with more than 900 additional people expected to be enrolled in the months to come.

Unfortunately, those 900 won't include the people still waiting. I spoke with John Peebles, the operations manager for the communicable disease branch of N.C.'s Department of Health and Human Services, for an explanation. He said that N.C.'s ADAP has only been opened to new enrollees who are at 125 percent or less of the federal poverty line, and that it will likely close again early next spring. (Those still on the state's waiting list have an income between 126 percent and 300 percent of the federal poverty line; 300 percent is N.C.'s general cutoff for ADAP enrollees.) This decision was made to ensure the program will be able to continue to cover all current and new enrollees year after year, with no fear of having to disenroll anyone, Peebles said.

Peebles added that the new $14 million doubles the state's contribution to ADAP, so N.C. itself is now paying for over 50 percent of its ADAP costs (the rest is provided through federal programs such as the Ryan White CARE Act). "That's unheard of, nationally," Peebles said. "It's a real coup to get the support of the governor and the general assembly [for ADAP] in a conservative state. We're setting the pace for other states to deal with this crisis."

But despite the sharp reduction in N.C.'s waiting list, numbers keep going up nationwide. As of July 22, there were at least 2,158 people waiting for ADAP enrollment, up from 2,090 on July 1 (which was itself an all-time high). Two new states, Georgia and Ohio, have started waiting lists, with Ohio not yet reporting how many people are on its list.

Earlier this month, U.S. Department of Health and Human Services (DHHS) Secretary Kathleen Sebelius announced a $25 million reallocation of federal funds for ADAP. According to the DHHS, the funds will be available in mid-August and "will meet the [ADAP's] projected need through the end of the fiscal year."

While this is certainly a first step toward ending the waiting lists, the AIDS Healthcare Foundation responds that $25 million will "barely be enough to cover the ... people who are currently on waiting lists -- without taking into account new patients enrolling and further state budget cuts."

Others agreed. "It is evident by today's announcement that the Obama Administration is making a concerted effort to deal with the growing ADAP crisis," said Paul Kawata, Executive Director of the National Minority AIDS Council (NMAC). But he also called the $25 million "a temporary band-aid for a situation that needs a long-term solution," and cautioned, "If we fail to allocate the necessary resources to deal with this challenge once and for all, we will continue to fall short of helping the very people who need it most."

The $25 million is also less than 20 percent of what was proposed in the ACCESS ADAP Act, which was put together in May by Sens. Burr, Coburn and Enzi. It recommends giving $126 million from stimulus funds to the DHHS for ADAPs. However, there hasn't been any action on the bill since May. In his speech at the XVIII International AIDS Conference last week, former U.S. President Bill Clinton encouraged activists to work with Congress to get the votes needed for more money, stating, "There is no way the White House will veto an increase in funding for AIDS."

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