January 13, 2011
While Virginia has seen a surge in people needing help from its AIDS Drug Assistance Program in recent years, state and federal support have remained flat, say health officials. To ensure ADAP does not run out of money before the grant year ends in March, administrators narrowed enrollment criteria, among other measures.
An estimated 760 clients are being disenrolled by more restrictive eligibility criteria, with state workers assisting most in transitioning to private charity programs run by AIDS drug manufacturers, according to a Dec. 7 letter from Dr. Karen Remley, Virginia's health commissioner. Disenrollment criteria include having joined the program most recently and having not picked up medications in the past five months; CD4 cell counts are also a consideration.
"We have experienced a fairly significant increase in enrollment, about a 21 percent increase in enrollment from 2007 to 2009," said Dr. Maureen Dempsey, Virginia's chief deputy of public health. "At the same time, we also saw an increase in medication costs. Folks are living longer with HIV. ... As new medications get added to those regimens and as they live longer, the cost of maintaining those regimens increases as well."
Other cuts include drug formulary limits; limiting new enrollments to children, pregnant women, and people with HIV-related opportunistic infections; and limiting prescriptions to 30-day supplies.
"Federal funding over the last few years has been stable," said Kathy Hafford, director of the disease prevention division at the state Department of Health. "We currently receive a little over $21 million in federal ADAP money," she said. "That put us slightly ahead of last year's money, which was $20.6 million," although this year's figure includes supplemental dollars added by the federal government to address financial stresses on ADAPs nationally, she noted.
Of the 150 HIV patients seen at the Cross Over Ministry's free clinics in Richmond, about 15 have been disenrolled from ADAP, including some based on CD4 counts, officials there said.