ADAP Waiting List Update: 31 People in 3 States as of April 11

April 15, 2013

As of April 11, 2013, there are 31 individuals on ADAP waiting lists in three states. Idaho and South Dakota saw decreases of 14 and 30 individuals respectively, in the last month. Florida has not formally closed their waiting list, but continues to enroll clients into their program and does not have any individuals on the waiting list.

Congress finalized a Continuing Resolution (CR) to fund the government for the remainder of FY2013 in March. The CR does not include the $35 million in emergency relief funds (ERFs) announced by President Obama on World AIDS Day (December 1, 2011) and awarded to 15 states and territories in August 2012. NASTAD is working alongside other HIV/AIDS organizations to ask the Administration to transfer funds to ADAPs to address the cut. In addition, sequestration took effect on March 1, 2013. Details on how the Health Resources and Services Administration (HRSA) will implement the additional 5.2% sequestration cuts as well as any other cuts are expected in the next few weeks.

Based on recent developments at the federal level, NASTAD believes that waiting lists will soon begin to increase as states examine and review their FY2013 funding levels. NASTAD estimates that due to the loss of the $35 million ERF funds 7,920 current ADAP clients could lose access to life-saving medications. NASTAD monitors cost containment measures for ADAPs on a weekly basis and currently publishes the ADAP Watch monthly. If waiting lists begin to grow as a result of the above fiscal issues, NASTAD will publish the ADAP Watch more frequently.

Finally, additional changes to the Ryan White Part B/ADAP formula distribution will take effect for FY2013. These will also likely result in funding shifts for state ADAPs. Only name-based HIV cases reported to CDC will be used in the formula calculations and the hold harmless provision will also decrease to 92.5% of states' FY2012 award. Ongoing shifts in the proportion of the nation's living HIV/AIDS cases will occur as well.

The President's FY2014 budget proposal was released on April 10, 2013. The proposal includes an increase of $20 million from FY2012 for a total of $2.4 billion for Ryan White Programs. The proposal includes an increase of $10 million for ADAP, $10 million for Ryan White Part C above FY2012 funding levels and the $35 million in President's World AIDS Day 2011 ADAP emergency relief funding (ERF).

Uninsured or underinsured individuals living with HIV who are ineligible for ADAPs can access needed medications using the common patient assistance program (PAP) application form to apply for multiple PAPs. This form can be found on NASTAD's website and the HRSA website. To see additional information on pharmaceutical company patient assistance or co-payment assistance programs, please visit the Positively Aware website or the Fair Pricing Coalition's website.

Please contact Christopher Cannon if you have questions.

ADAPs With Active Waiting Lists (31 Individuals in 3 states, as of April 11, 2013)
StateNumber of Individuals on ADAP Waiting ListPercent of the Total ADAP Waiting ListIncrease/Decrease from Previous Reporting PeriodDate Waiting List Began
Florida00%0June 2010
Idaho1445%-14October 2012
South Dakota1755%-30August 2012

ADAPs With Other Cost-Containment Strategies (From April 1, 2012 through February 6, 2013*)

Enrollment Cap:

Expenditure Cap:
Illinois: (monthly)
Kentucky: (annual)
New Mexico: (monthly)
South Dakota: (annual)

Formulary Reduction:
Puerto Rico
Virgin Island (U.S.)

Montana: elimination of all support services
Washington: pay insurance premiums only if client is prescribed and taking ARVs

* ADAPs may have other cost-containment strategies that were instituted prior to April 1, 2012.

ADAPs Considering New/Additional Cost-Containment Measures (Before March 31, 2013**)

Alabama (capped enrollment)
Maine (formulary reduction)

** March 31, 2013 is the end of ADAP FY2012. ADAP fiscal years begin April 1 and ends March 31.

ADAPs That Eliminated/Modified Cost-Containment Measures (Since December 17, 2012***)

North Carolina (formulary increased)

*** ADAPs may have eliminated/modified other cost-containment strategies prior to December 17, 2012.

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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