The ADAP Watch
October 8, 2010
As of October 7, 2010, there were 3,586 individuals on AIDS Drug Assistance Program (ADAP) waiting lists in 8 states. This is a 52 percent increase from the 2,359 individuals on the July 2010 ADAP Watch. Twenty ADAPs, seven with current waiting lists, have instituted additional cost-containment measures since April 1, 2009 (reported as of September 29, 2010). In addition, 14 ADAPs, including two 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, 26 states have implemented or are anticipating implementing cost-containment measures (reported as of September 29, 2010). Five 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, 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. ADAPs nationally experienced unprecedented client growth from FY2008 to 2009 with an average monthly growth of 1,271 clients (an increase of 80 percent from FY2008 when the average monthly growth was 706 clients over FY2007).
Thirty ADAPs recently received a total of $25 million in emergency funding. As a result of this funding, five ADAPs were able to eliminate their waiting list. States also recently received approximately $17 million in Ryan White Part B Supplemental grants which many are using to address ADAP shortages. In August, President Obama sent Congress a revised budget requesting a total increase of $50 million for ADAPs in FY2011. This is an increase of $30 million over his earlier budget request of $20 million. The revised request notes that the $30 million increase will go towards the Part B supplemental awards and will continue funding to states receiving awards through the $25 million of emergency ADAP funding. Both the House and Senate Appropriations Committees are currently recommending an increase of $50 million for ADAPs in FY2011, which includes the $25 million in reprogrammed FY2010 funding. NASTAD and the HIV/AIDS community continue 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 (3,586 Individuals in 8 States*, as of October 7, 2010)
Florida: 2,015 individuals
ADAPs With Other Cost-Containment Strategies (Instituted Since April 1, 2009, as of September 29, 2010)
Arizona: reduced formulary
ADAPs Considering New/Additional Cost-Containment Measures (Before March 31, 2011***)
Arizona: establish waiting list
* As a result of ADAP Emergency Funding, Hawaii, Idaho, Kentucky, South Dakota, and Utah have eliminated their waiting lists.
ADAPs With Current or Anticipated Cost-Containment Measures, Including Waiting Lists, October 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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