Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date. 
NASTAD Press Release - December 15, 2004
For further information, contact: Murray Penner, (202) 434-8090
Washington, DC - The National Alliance of State and Territorial AIDS Directors (NASTAD) has released its latest ADAP Watch, a listing of AIDS Drug Assistance Programs (ADAPs) that have implemented or anticipate implementing cost containment strategies to maximize program resources and maintain fiscal viability (see attached NASTAD ADAP Watch for details). These strategies all have a significant impact on client access to life-saving medications.
With current program funding falling far short of meeting the demand of those in need, 813 people are currently on ADAP waiting lists in nine (9) states, awaiting access to life-sustaining drugs. On June 23, 2004, President Bush announced a plan to immediately provide one-time funding of $20 million to provide medications to people on ADAP waiting lists in ten (10) states (registered as of June 21, 2004). The program is being administered outside of ADAPs, with the Health Resources and Services Administration (HRSA) coordinating the program with the ten states (see attached NASTAD fact sheet on the Initiative for additional details). All but 55 of the individuals on the current waiting lists are slated to be covered under this Initiative and approximately 591 individuals have begun to receive medication under it.
In addition to waiting lists, which are only one indicator of fiscally constrained ADAPs, many states have instituted other cost-containment measures that limit access to HIV medications for low-income Americans. Only two of these states are eligible to receive assistance from the President's Initiative. Since April 2003, thirteen (13) ADAPs have initiated other cost- containment measures, including capped enrollment, limited formularies, lower financial eligibility criteria, monthly or annual expenditure caps, or cost-sharing. In addition, six (6) states anticipate the need to implement new or additional cost- containment measures during the 2004 ADAP fiscal year which ends March 31, 2005.
A teleconference call, hosted in conjunction with the Kaiser Family Foundation, will take place at 12:30 pm EST on Wednesday, December 15, 2004 to discuss this release as well as issues related to the President's ADAP Initiative. The call can be accessed by dialing 1-800-311-9402 (Password ADAP). Presentation materials will be available at: www.kff.org/hivaids/hiv121504pkg.cfm.
The overall future prospect of funding for ADAPs is bleak, as are the prospects for transitioning individuals from the President's $20 million Initiative into ADAPs when the funding runs out. "We are extremely troubled that there is no plan to continue to provide medications for these people on waiting lists," remarked Julie Scofield, NASTAD Executive Director. "This is an ongoing, severe crisis in which many states are struggling desperately to provide these life-saving medications to people in need. This one-time infusion of funds is greatly appreciated, but it does not solve the ongoing ADAP fiscal crisis. Unfortunately, programs will continue to make difficult decisions to keep programs solvent," Scofield added.
Federal funding for ADAPs has been insufficient to meet the needs of those eligible and has led to this fiscal crisis for many ADAP programs. The recently approved Consolidated Appropriations Act provided an increase of $38.7 million for ADAPs in FY2005. NASTAD is very concerned that this funding level provides only a small portion of the $217 million increase needed for ADAP programs, and provides no continuation of the $20 million funding in order to transition clients from the President's Initiative into ADAPs. There is no guarantee that individuals receiving medication through the Initiative will be covered by ADAPs when the FY2005 ADAP fiscal year begins on April 1, 2005. In addition, cuts have again occurred in other programs within the Ryan White CARE Act, including Title II grants which provide funding to states for other critical HIV/AIDS services. AIDS treatment policy experts have determined that a minimum of a $100 million increase is needed for ADAPs in FY2006 in order to alleviate restrictions and address the nation's ADAP crisis.
ADAPs provide HIV treatments to low income, uninsured, and underinsured individuals living with HIV/AIDS in all 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, three U.S. Pacific territories (Guam, the Northern Mariana Islands, and American Samoa) and one Associated Jurisdiction (the Republic of the Marshall Islands). Each year approximately 135,000 people receive services from ADAPs, representing about 30% of people estimated to be living with HIV/AIDS in care in the U.S. ADAPs are a discretionary grant program funded through the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. Because ADAPs are not entitlement programs, funding levels are not based on the number of people who need prescription drugs or the cost of medications. In addition to federal funding, ADAPs may also receive state general revenue support and other funding, but these other sources are highly variable and dependent on local decisions and resource availability.
The ADAP Watch (December 15, 2004)
President Bush's $20 Million ADAP Initiative
Source:
NATIONAL ALLIANCE OF STATE AND TERRITORIAL AIDS DIRECTORS (www.nastad.org)
444 N. Capitol Street, NW #339
Washington, DC 20001-1512
FAX - 202-434-8092
PHONE - 202-434-8090
041215
NA041201
Copyright © 2004 - Reproduced courtesy of copyright owner - listed on source line.
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Broadway Cares/Equity Fights AIDS, Elton John AIDS Foundation, the National Library of Medicine, Pacific Life Foundation and donations from users like you.
Always watch for outdated information. This article first appeared in 2004. This material is designed to support, not replace, the relationship that exists between you and your doctor.
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980, 2004. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .