The ADAP Watch
July 30, 2010
As of July 29, 2010, there were 2,359 individuals on AIDS Drug Assistance Program (ADAP) waiting lists in 13 states. This is a 65 percent increase from the 1,431 individuals on the June 2010 ADAP Watch. Sixteen ADAPs, seven with current waiting lists, have instituted additional cost-containment measures since April 1, 2009 (reported as of July 22, 2010). In addition, 13 ADAPs, including three with current waiting lists, reported they are considering implementing new or additional cost-containment measures by the end of ADAP's current fiscal year (March 31, 2011).
States that have instituted cost containment measures and those considering them, in addition to implementing waiting lists, are reducing program financial and medical 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. Two states disenrolled clients as their programs decreased income eligibility levels. In total, 27 states have implemented or are anticipating implementing cost-containment measures (reported as of July 22, 2010). Two additional states reported that they project implementing a waiting list in ADAP FY2011 (beginning April 1, 2011).
The program's viability depends on federal funding awards and state general revenue support for the state's fiscal year (in most states this began on July 1, 2010). With growing client demand for ADAP services (from FY2008 to 2009, ADAPs nationally experienced an average monthly growth of 1,271 clients, an unprecedented increase of 80 percent from FY2008 when the average monthly growth was 706 clients over FY2007), minimal federal increases and continued cuts in state funding, it is paramount that emergency federal resources be made available to stave off the crisis many ADAPs and the clients they serve are facing. NASTAD and the HIV/AIDS community have been and will continue advocating for $126 million in additional FY2010 federal funding.
The Obama Administration recently announced that it is reprogramming $25 million to address ADAP waiting lists and other unmet ADAP needs (this funding is expected to be distributed in mid-August). In addition, approximately $17 million in Ryan White Part B Supplemental grants will be distributed to states in early August and is expected to be used in many states to help address ADAP needs. The House Labor-HHS-Education Appropriations Subcommittee recommended an increase of $50 million for ADAPs in FY2011, which includes the $25 million in reprogrammed FY2010 funding. The Senate Labor-HHS Appropriations Subcommittee has also recommended an increase of $50 million. NASTAD continues to advocate for additional resources for FY2010 and FY2011 and urges Congress to provide its fair share of increased resources to address the ADAP crisis.
The ADAPs on the following page reported cost containment strategies to NASTAD. Other ADAPs may be considering changes but due to unfinished state budget processes, political factors and other considerations, have not reported them.
ADAPs With Waiting Lists (2,359 Individuals in 13 States, as of July 29, 2010)
Florida: 925 individuals
ADAPs With Other Cost-Containment Strategies (Instituted Since April 1, 2009, as of July 22, 2010)
Arizona: reduced formulary
ADAPs Considering New/Additional Cost-Containment Measures (Before March 31, 2011***)
Arizona: establish waiting list
*Louisiana has a capped enrollment on their program. This number is a representation of their current unmet need.
ADAPs With Current or Anticipated Cost-Containment Measures, Including Waiting Lists, July 2010
This article was provided by National Alliance of State and Territorial AIDS Directors. Visit NASTAD's website to find out more about their activities and publications.
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