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ADAP Pill Box: All Things ADAP
The ADAP Advocacy Association (aaa+) is pleased to publish its inaugural electronic issue of the "ADAP Pill Box" - a monthly publication focusing entirely on issues relating to the AIDS Drug Assistance Programs (ADAPs). The ADAP Pill Box will cover ADAP-related news and developments at the national level, as well as the state and local levels. This new publication is part of our "End The Wait" campaign, designed to raise awareness about ADAP waiting lists and the perpetual under-funding of the AIDS Drug Assistance Programs.
aaa+ invites you to share the ADAP Pill Box by forwarding it to your friends and colleagues, and encourage them to join aaa+ on our our website. Tell them that individual membership is free. Also, please feel free to forward appropriate ADAP-related news items to aaa+ so that we can include them in the next edition.
Additionally, aaa+ invites you to apply for our special VisaŽ Platinum credit card through Capital OneŽ Card Lab Connect. As a valued supporter, 1% of every purchase you make is automatically donated to our organization. Plus, Capital OneŽ will donate $25 after you make your first purchase.
Apply now and you can make supporting our cause a simple every day event. To apply online, go to https://www.cardlabconnect.com/AffinityPortal/visitorAction.do?affinityName=EndTheWait.
There is no better way to support our "End The Wait" campaign. By applying for our special VisaŽ Platinum credit card through Capital OneŽ Card Lab Connect, you can help raise awareness about ADAP waiting lists, raise money for the ADAP Advocacy Association and enjoy the benefits of your new VisaŽ Platinum credit card.
Get all of the competitive credit card benefits you want and expect as well as a simple way to support our "End The Wait" cause. This Capital OneŽ Visa Platinum card has:
No Annual Fee
Low Introductory Purchase Rates
Custom card designs - show support and help spread the word
1% of every purchase automatically donated to our organization
So sign up online at online. We appreciate your ongoing support and invite you to take advantage of this special offer today!
Thank you.
Brandon M. Macsata, CEO
ADAP Advocacy Association (aaa+)
INSIDE THIS ISSUE
NATIONAL: NASTAD Releases January 2010 ADAP Watch
NATIONAL: Waiting List Grows for Cash-Strapped AIDS Drug Programs, Coalition Says
NATIONAL: Plunge in state revenue triggers AIDS funding 'crisis'
NATIONAL: Little-Known Program Tries to "Bridge the Gap" for People on ADAP Waiting Lists
STATE: HIV Program Caps Enrollment
STATE: State Rep Sara Feigenholtz Takes Aim at Looming Financial Crisis in Illinois AIDS Drug Assistance Program
STATE: State AIDS Funds Face Budget cuts
Other news of interest
The ADAP Advocacy Association is a proud community partner of Washington, DC's "The Cherry Fund" - which is an independent, all-volunteer 501(c)(3) foundation whose sole purpose is to raise funds for the HIV/AIDS youth service community. The Fund focuses on organizations combating the spread of HIV infection & AIDS through prevention, treatment, and education in the nation's youth community. Learn more at online at http://www.cherryfund.org/.
NATIONAL NEWS...
NASTAD Releases January 2010 ADAP Watch
January 25, 2010
The National Association of State & Territorial AIDS Directors (NASTAD) released its January 2010 edition of ADAP Watch. As of January 8th, there were 540 individuals on ADAP waiting lists in nine states - including 11 individuals in Arkansas, 34 individuals in Iowa, 140 individuals in Kentucky, 20 individuals in Montana, 27 individuals in Nebraska, 20 individuals in South Dakota, 209 individuals in Tennessee, 65 individuals in Utah and 14 individuals in Wyoming.
Read ADAP Watch - January 2010
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Waiting List Grows for Cash-Strapped AIDS Drug Programs, Coalition Says
By Anne L. Kim, CQ HealthBeat News
January 21, 2010
A national coalition of HIV/AIDS groups says a drug assistance program for needy patients requires an additional $126 million in emergency funding for fiscal year 2010 to be able to continue to provide medication assistance for its current patients and also meet growing demand.
"The funding levels are far from what is needed," said Carl Schmid, deputy executive director of The AIDS Institute, concerning the AIDS Drug Assistance Program funded under the Ryan White HIV/AIDS Treatment Extension Act.
Schmid's group is a member of the Federal AIDS Policy Partnership, which held a congressional briefing Thursday on the impact of state budget cuts on HIV/AIDS programs.
As of January 7, 2010, 540 people were on waiting lists for the drug assistance program in Arkansas, Iowa, Kentucky, Montana, Nebraska, South Dakota, Tennessee, Utah, and Wyoming, according to a survey by the National Alliance of State and Territorial AIDS Directors.
This number is "troubling," said Heather L. Hauck, Maryland's director of Infectious Disease and Environmental Health Administration, who is also a member of the National Alliance of State and Territorial AIDS Directors. Two years ago, there was no waiting list, Hauck said.
According to figures provided by the AIDS directors group, this number has fluctuated since 2002, with a high of 1,629 in 2004 and a low briefly reaching zero in 2007. Since then, the number of people on the program's waiting list has been increasing steadily, but has not risen to levels that ranged from approximately 540 to 1,600 between 2002 to 2004.
The current waiting list can be attributed to a combination of factors including state economic woes, a rise in new infections, aggressive testing efforts and people losing their health insurance, Schmid said.
States don't have the money to contribute additional funds, and that's why more federal assistance is needed, he added.
If emergency assistance isn't provided for the current fiscal year, the program will need an additional $370.1 million in fiscal year 2011 for a total of $1.2 billion to meet needs, according to Schmid.
State budget cuts have resulted in a decline in funding for HIV/AIDS programs, particularly in preventive services, that have trickled down to the county and individual organization level while at the same time the number of patients needing HIV/AIDS services has increased, according to panelists who spoke at the briefing.
"We have a double whammy," Schmid said.
According to the survey by the National Alliance of State and Territorial AIDS Directors, state budget cuts have resulted in a reduction of more than $170 million from HIV/AIDS program budgets in 29 states.
In Los Angeles County, where an estimated 61,000 people live with HIV/AIDS, state funding for HIV/AIDS programs decreased from approximately $24.3 million in 2008-2009 to $13.4 million in the 2009-2010, according to Mario J. Perez, director of the county's public health department's Office of AIDS Programs and Policy.
The most significant cut proportionally was in prevention services, he said. Los Angeles and similar jurisdictions have seen a loss of about 73 percent of state funding for preventive services since 2006. "The prevention cuts really sort of compromised our efforts," Perez said.
And while the county kept its HIV counseling and testing programs fully intact, it made cuts to other programs like its peer support and case management services, he said.
For the organization AIDS Project Los Angeles, state budget cuts have meant cuts to the organization's wellness center and home health services as well as salary freezes, said Phillip Curtis, the organization's director of government affairs. But cuts to preventive services are nothing new - something that has been "peeling away over time," Hauck said. "We're really again at the level where we're making very hard decisions about where we invest our HIV prevention resources at this point."
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Plunge in state revenue triggers AIDS funding 'crisis'
By Posted by Lou Chibbaro Jr., DC Agenda
January 22, 2010
The worst economic recession since the Great Depression is devastating state and local government budgets, especially HIV/AIDS budgets, a panel of AIDS experts said Thursday.
In a briefing on Capitol Hill for congressional staff members, state and local AIDS office officials from Maryland and California, along with leaders of AIDS service groups in Los Angeles and Louisville, Ky., said they were scrambling to carry out their work in the midst of unprecedented state budget cuts.
(PHOTO: Carl Schmid, Deputy Executive Director of the AIDS Institute. DC Agenda photo by Michael Key)
Facing a multi-billion dollar deficit, California slashed its state AIDS budget by $85 million, resulting in what two of the panelists from Los Angeles called crushing budget cuts for HIV prevention and treatment programs.
"To say that we were shocked is to put it mildly," said Phillip Curtis, director of government affairs for AIDS Project Los Angeles.
Curtis and Mario Perez, director of the Los Angeles County Office of AIDS Programs & Policy, told about 25 Senate staffers in one of two presentations that cutbacks in HIV treatment and prevention programs could result in an increase in new HIV infections.
According to Curtis, AIDS Project Los Angeles lost $1.9 million in state funds, forcing it to lay off staff and reduce the HIV treatment and prevention services it provides to thousands of clients, including gay male and transgender clients.
Both said their respective agencies were continuing to assist a large number of clients and, in the case of Curtis's group, fundraisers were retained to solicit more private sector funds from foundations. Their main concern now, the two said, was the possibility of more state funding cuts in the next fiscal year.
Heather Hauck, director of the Maryland Department of Health & Mental Hygiene's infectious disease division, said her state's HIV programs were hit with a $786,720 budget cut in fiscal year 2009 and a $702,768 cut in fiscal 2010. She noted that the cuts have resulted in some staff layoffs, furloughs and salary reductions.
Pointing to a national survey, she said state revenue shortfalls due to the recession are forcing many states to reduce their contribution to the joint state-federal AIDS Drug Assistance Program, known as ADAP.
Hauck said the cutbacks have resulted in at least nine states running out of funds to provide life-saving antiretroviral drugs to all the low-income HIV patients that need them. The funding shortfall means these and possibly other states must establish waiting lists for patients to obtain ADAP funded drugs.
Maryland, Virginia and D.C. are not among the jurisdictions forced to set up ADAP waiting lists, according to information Hauck provided. But she and the other panelists expressed concern that unless the federal government boosts its share of ADAP funding, waiting lists will surface in more states.
Carl Schmid, deputy executive director of The AIDS Institute, a Washington-based advocacy group, said state and local AIDS office officials are calling on the Obama administration to help offset the state budget cuts by increasing funds for the Ryan White Care Act. The Ryan White program is the federal government's main funding source to state and local AIDS agencies.
Schmid said a coalition of AIDS organizations called the Federal AIDS Policy Partnership wants the administration to ask Congress to appropriate $3.1 billion for the Ryan White program in fiscal year 2011, representing an increase of $818 million over the fiscal year 2010 funding.
He said the coalition also wants Congress to approve an emergency supplemental budget allocation of $126 million this year for ADAP.
"We know times are tight, but there are a lot of people's lives at stake," Schmid said.
Bobby Edelen, president of the Kentucky HIV/AIDS Advocacy Action Group and a person living with AIDS, told the briefing that the lives of many of the people his organization assists in Louisville and other cities are being placed in jeopardy over his own state's budget cuts.
"You've heard enough about numbers," he said. "I'm here to talk about the personal side of this. I've been living with this disease for 20 years."
He said an ADAP waiting list in Kentucky is likely to result in a decline in health of people with HIV that he knows personally.
"You're going to lose some people if they can't get the treatment and services they need," he said. "I understand that money is tight. But we are the greatest nation on earth. We can make things possible."
The four panelists and Schmid, who served as moderator, conducted a morning briefing at the Dirksen Senate Office Building for Senate staffers and an afternoon briefing at the Rayburn House Office Building for U.S. House staffers.
Link to DC Agenda article
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Little-Known Program Tries to "Bridge the Gap" for People on ADAP Waiting Lists
By Becky Allen, The Body.com
January 15, 2010
Nine U.S. states now have waiting lists for their AIDS Drug Assistance Programs (ADAPs), state-funded programs that help low-income HIVers pay for the medications they need. As a growing number of people are forced to wait for ADAP access, many of them need to seek out other programs that can help cover medication costs in the meantime. Bridge the Gap is one such program.
"There's a problem here. There's a need, and the demand is not being met by the federal dollars that are allocated," says Gregory Edwards, Ed.D. He's the executive director of the Flowers Heritage Foundation, the nonprofit group that runs Bridge the Gap. Bridge the Gap is designed to raise funds and distribute them to people on ADAP wait lists for them to use for buying HIV-related medications.
Bridge the Gap was founded in 2006 and initially served 13 people in Montana. The Flowers Heritage Foundation was created by Ramsell Holding Corporation, a pharmacy benefits management company. "Upon learning that the state of Montana had people going on a wait list [in 2006], they thought it simply made sense to give back to the larger and broader community in this fashion, so they created the Bridge the Gap program," Dr. Edwards says.
Since 2006, the amount of people on waiting lists nationally has fluctuated, and Bridge the Gap has attempted to adjust to meet those needs. Currently, Bridge the Gap funds HIV-related medications for 34 people in Montana, at a cost of between $10,000 and $12,000 per person per year, Dr. Edwards says. Now that more states are creating waiting lists, the program is hoping to get involved with additional states.
The decision of whether to expand to include more states is not up to Bridge the Gap, according to Dr. Edwards. He says it is up to each state's ADAP director to decide to participate and enroll their wait-listed people. "We could not take any initiative to decide who to fund, or not fund. That's why the impetus is on the state directors to enroll in the program," Dr. Edwards explains.
Once a state has agreed to use the program, that state's ADAP director can access a live, Web-based system and enroll people in Bridge the Gap, Dr. Edwards says. "As funds become available, whoever's at the top of the list is immediately funded," he explains. The list is first-come, first-served: The people who were enrolled the longest ago are at the top of the list, Dr. Edwards says. Bridge the Gap funds go directly to the person's local pharmacy and cover all medications listed on the state's ADAP formulary, Dr. Edwards says. The entire process is completely anonymous: No one at Bridge the Gap even knows its enrollees names or locations, Dr. Edwards notes.
"What makes our program particularly unique at the Flowers Heritage Foundation is that Ramsell [the parent company] also covers all of our administrative costs, 100 percent," says Dr. Edwards. "One hundred percent of all dollars donated go directly to our patients and charitable causes and programs. So 100 percent of the funds people donate for the Bridge the Gap go to fund medication for people living with HIV and AIDS in the U.S."
Until now, virtually all of Bridge the Gap's funding has been provided by Ramsell, but the program has begun seeking out additional means of support. Late last year, it partnered with the National Minority AIDS Council (NMAC) to raise awareness of the program -- and to reach out for donations. "To date, some 95 percent of the funds have come from Ramsell," says Dr. Edwards. "We've also received a huge grant from the MAC AIDS Foundation. The other funds have come from individual donors."
It's those individual donors that Dr. Edwards hopes will become more active. "We know that different people support different organizations for different reasons," he explains. That's why Bridge the Gap is partnering with a variety of groups, including POZ magazine, the National Association of People With AIDS and the Black AIDS Institute, as well as NMAC. "We're trying to create an 'Obama-esque' system of getting people to donate five, 10, 20 dollars each," Dr. Edwards says. (People can use PayPal to donate to the Flowers Heritage Foundation online) For now, however, the program remains funded primarily by Ramsell.
Meanwhile, only Montana officially is enrolled with Bridge the Gap, although Utah and Tennessee are both considering it, according to Dr. Edwards. Late last year, the National Alliance of State and Territorial AIDS Directors (NASTAD) sent a memo to all states with ADAP waiting lists, letting them know about Bridge the Gap as an option. Dr. Edwards says NASTAD is planning to send another memo soon, this time to every state.
As ADAP waiting lists grow in more U.S. states, the need for programs like Bridge the Gap grows with them. "We're still waiting for the word to get out about Bridge the Gap, and to enroll other states," says Dr. Edwards. "It's really up to the state ADAP directors to take the initiative."
Link to The Body.com article
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ACROSS THE NATION...
HIV Program Caps Enrollment
By Sarah Avery - Staff Writer, The Raleigh News & Observer
January 26, 2010
RALEIGH, NC - The state's drug assistance program for HIV patients has been capped at its current enrollment, with budget cuts hitting at the same time more people need help, state officials said Monday.
The AIDS Drug Assistance Program picks up the cost of life-saving anti-retroviral regimens and other drugs for low-income people infected with HIV, the virus that causes AIDS.
Without the drugs, the virus can multiply, making the person sick and potentially more contagious. As a result, denying people medicine worries public health officials.
"You don't want people who are currently on medications to lose that access," said Jacquelyn Clymore, head of the state's HIV/STD Prevention and Care branch.
Last year, state legislators allocated $11 million for AIDS drug assistance - about half of what had previously been budgeted, Clymore said.
At the same time, the state's unemployment rate has spiked upward, hitting a record 11.2 percent last month. For many, that means also losing job-sponsored health insurance to cover pricey HIV drugs.
About 4,400 people are using the drug assistance program, compared with 4,000 this time last year, Clymore said. As of Friday, no more people can be added, she said.
"The economic challenges are immense," Clymore said, adding that nine other states have frozen enrollment for their drug assistance programs. "This is by no means the only state having this experience."
North Carolina's program had long been the least generous in the nation, until state lawmakers loosened the eligibility criteria in 2006 and federal officials reworked the funding formula.
In 2008, the last full year for which data was available, more than 23,000 people in North Carolina were living with HIV or AIDS.
Link to Raleigh News & Observer article
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State Rep Sara Feigenholtz Takes Aim at Looming Financial Crisis in Illinois AIDS Drug Assistance Program
Posted by David Ormsby, The Illinois Observer
January 25, 2010
CHICAGO, IL -State Rep. Sara Feigenholtz (D-Chicago), Chair of the Human Services Appropriations Committee, on Friday convened the committee at a public hearing to tackle the looming financial crisis in the Illinois AIDS Drug Assistance Program (ADAP) and HIV prevention programs.
The state AIDS drug program, which currently 4,600 people, is under siege from unprecedented demand due to Illinois' economic turbulence and spiraling unemployment which stands at 11.1% in the state.
Program demand is expected to grow by 15% in 2010 and will need an additional $10 million to meet the growth, according to the AIDS Foundation of Chicago.
"The AIDS Drug Assistance Program is a lifeline for over 4,600 low-income, uninsured people every month, but demand for the program is skyrocketing," Feigenholtz said. "Approximately 105 new people apply monthly."
"The need to maintain ADAP has forced the state to cut back on funding for HIV prevention services, which will only result in more HIV cases and more uninsured people who need ADAP. We need a balanced and sustainable solution to this public health emergency."
The Illinois Department of Public Health estimates the ADAP clients use 8,500 prescriptions monthly. And the cost of medications to the department have zoomed from $2.0 million monthly to $3.5 million, Feigenholtz says.
One of those clients is Matt Appleman from Dixon, IL. Appleman turned to ADAP because health insurance companies refused to sell him insurance coverage due to his HIV status.
"My HIV medications cost over $20,000 a year, but that's what keeps me healthy and able to run my business," said Appleman, who testified Friday.
"If I couldn't get HIV medications through ADAP, I'd probably get so sick that I'd have to shut down my business and go on disability. I'd get HIV meds, but I'd have lost everything else."
The state of Illinois faces nearly a $13 billion budget deficit, the second largest in the nation, and has been reduced to paying its bills to vendors, on average, six months late.
The state does not have an extra $10 million laying around. It's broke.
Governor Pat Quinn has been urging - pleading - with the Illinois legislature to raise the state's income tax to maintain the state's vital programs, such as ADAP. But his pleas have tumbled into a rabbit hole.
The Illinois General Assembly returns to "work" after the February 2 primary election. But informed observers expect lawmakers to punt on any income tax to avoid the wrath of surly voters in November.
Prognosis: not good.
Link to Illinois Observer blog
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State AIDS funds face budget cuts
By John Fenoglio, The Windy City Times
January 21, 2010
CHICAGO, IL - People living with HIV/AIDS who also rely on the state's AIDS Drug Assistant Program ( ADAP ) are especially vulnerable in this climate of economic unrest. That was the subject of the AIDS Foundation of Chicago's ( AFC's ) Service Provider Council's Policy and Advocacy Committee meeting Jan. 14 at the organization's office, 200 W. Jackson.
This year Illinois faces a $12 billion deficit. In an effort to balance the budget, lawmakers are looking for ways to trim spending wherever they can. This means state-funded programs, like ADAP, face sharp budget cuts.
According to John Peller, AFC's director of government relations, "Without additional state funding, hundreds of people with HIV will be cut from the program or put on a waiting list."
Compounding ADAP's funding crisis is the number of people enrolling in the program, which is expected to increase 15 percent in 2010. At a time when Illinois is already projected to spend $18 million on ADAP this year, AFC reports that the program needs an additional $10 million to keep pace with new enrollment, and meet the needs of current clients.
More than 4,000 people will seek ADAP services each month. Yet, it is the human toll behind these numbers that is staggering. Most ADAP recipients have no other options for accessing HIV medications. Without access to these medications on a daily basis - if people are, in fact, put on waiting list, or cut from the program due to budget cuts - the results could be fatal.
"ADAP cuts and waitlists interrupt or delay HIV treatment, causing deadly health risks for people with HIV. People rely on these services to survive," said Pellar.
In response to the state's HIV funding crisis, the Illinois House Appropriations-Human Services Committee will hold a hearing Friday, Jan. 22 at the James R. Thompson Center, 100 W. Randolph, at 10 a.m. in Room 16-504. The meeting is open to the public.
For more information on ADAP's Jan. 22 meeting or to learn more about AFC, visit www.AIDSChicago.org.
Link to Windy City Times article
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