May 26, 2011
Funding for AIDS Drug Assistance Programs has not kept pace with demand, as states deal with the same economic downturn that has thrown many HIV-positive individuals off insurance rolls. As of May 19, 8,310 people in 13 states were on ADAP waiting lists, according to the National Alliance of State and Territorial AIDS Directors.
The real need, however, is presumably even greater. "States that have changed their eligibility programs or don't have a waiting list, or some states have disenrolled their patients -- that's kind of a silent crisis, I think," said Jeff Graham, executive director of Georgia Equality, an LGBT advocacy group. The budget for Georgia ADAP was recently cut by $100,000, even though its waiting list of 1,520 people is second only to Florida's, where 3,938 patients need assistance.
In July, Illinois will cut the maximum income level for ADAP clients from $54,450 annually to $32,670. Florida officials have held public hearings as they consider reducing their ceiling to $21,780. Utah and Alabama have reopened their waiting lists.
Nationally, ADAPs help about 174,000 low-income HIV/AIDS patients access treatment. Though mostly federally funded, ADAP is not an entitlement program, so potential applicants can be turned away at the state level due to lack of funding. This year's $885 million ADAP budget is $25 million more than last year's, said Brandon Macsata, CEO of the ADAP Advocacy Association.
Advocacy groups consider flagging ADAP funding by states to be short-sighted. Treatment enables patients to manage their disease and be economically productive, and it reduces the state's long-term medical costs and the risk of onward transmission, they say.
Most frozen-out patients find treatment through charity programs, but these often have bureaucratic barriers and may be dependent upon donations. In just four months, Virginia's three-person ADAP office has "transitioned" 203 former clients to such charity programs, officials said.