ADAP Crisis Deepens as More Are Disenrolled

On November 16, the ADAP Advocacy Association (aaa+) cautioned that the growing waiting lists under the AIDS Drug Assistance Programs (ADAPs) are only the "tip-of-the-iceberg" as thousands more are being adversely impacted by other cost containment strategies.

"ADAP waiting lists concern all of us, but there is so much more to the ongoing ADAP crisis," summarized Brandon M. Macsata, CEO of aaa+. "Unless something is done to adequately address the systemic federal funding shortfalls of the program, more and more people will be forced out of care, thus putting thousands of lives at risk for infection, health problems, and even death."

According to the aaa+ press release, several states have changed their program eligibility over the last year, thereby making clients who would have otherwise been eligible to receive services no longer eligible for ADAP (otherwise known as "disenrolled"). Arkansas reduced its financial eligibility to 200% of Federal Poverty Level (FPL), Utah reduced theirs to 250%, and Ohio, South Carolina, and North Dakota reduced their financial eligibility to 300% FPL. With these changes, many people living with HIV/AIDS could be forced to choose between basic necessities and their antiretroviral medications.

Beginning in February 2011, nearly 350 current recipients enrolled in Florida's ADAP will no longer be able to obtain their medication. The program in Florida is facing a $16 million shortfall. With 2,306 HIV-positive people already waiting to access their life-saving medications, Florida has the largest ADAP patient waiting list in the country.

Ohio has already disenrolled 257 clients and Utah has disenrolled 89 clients; these are only the numbers that have been publically reported and could actually be considerably higher.

While the number of people reported by the National Association of State and Territorial AIDS Directors (NASTAD) to be on waiting lists in nine states fell from 4,157 on October 28 to 3,811 on November 12, the decrease was probably due more to these changes than to anything positive. And it's not likely to get better anytime soon.

Due to their own budget crises, states have been forced to enact other cost containment measures which are potentially putting patient health at risk, including reduced drug formularies, monthly or annual expenditure caps, medical criteria, discontinued reimbursement of laboratory assays, client cost-sharing, and capped enrollment.

To learn more about the ADAP waiting lists or the ADAP Advocacy Association, please contact Brandon M. Macsata by phone at (305) 519-4256 or email at info@adapadvocacyassociation.org.