As of October 11, 2012, there were 104 individuals on AIDS Drug Assistance Program (ADAP) waitinglists in five (5) states.
This is a 91 percent decrease from the 1,125 individuals on the August 2012
ADAP Watch
.
Twenty ADAPs, including five with current waiting lists, have instituted additional cost-containment measures since April 1, 2009 (reported as of September 26, 2012). In addition, two ADAPsreported considering implementing new or additional cost-
containment measures by the end of ADAP’s
current fiscal year (March 31, 2013). At this time, three states have determined an enrollment cap fortheir program and anticipate reaching this cap and thus, beginning wait lists during the fiscal year.
ADAPs with Current or Anticipated Cost-Containment Measures, Including Waiting Lists,September 26, 2012
October 12, 2012
Waiting List Client Demographics:
African Americans and Hispanics represent 49% (32% and 17%,respectively) of clients on current ADAP waiting lists. Combined, Asians, Native Hawaiian/Pacific Islandersand Alaskan Native/American Indians represent approximately 5% of the total ADAP waiting list population.Multi-racial ADAP clients represent 1% of the total ADAP waiting list population. Non-Hispanic whitescomprise 41% of clients on ADAP waiting lists. Unknown is currently 1% of the total ADAP waiting list.Almost two-thirds (67%) of ADAP clients on waiting lists are men. Approximately one third (32%) of ADAPwaiting list clients are women. Transgender are only 1% of the ADAP waiting list.
Access to Medications:
Case management services are being provided to ADAP waiting list clients throughPart B (5 ADAPs), contracted agencies (2 ADAPs) and other agencies, including other Parts of Ryan White (3ADAPs).For clients on ADAP waiting lists who are currently on or in need of medications, all
five ADAPs
withwaiting lists confirm that ADAP waiting list clients are receiving medications through either pharmaceuticalcompany patient assistance programs (PAPs), Welvista, or other mechanisms available within the state.
Waiting List Organization:
An ADAP waiting list using a first-come, first-served model is structured toplace any individual applying to ADAP on the waiting list in order of receipt of a completed enrollmentapplication and eligibility confirmation. Of the five states with ADAP waiting lists, three
utilize a first-come, first-served model for prioritizing clients to join the active client roll.An ADAP waiting list using a medical criteria model is structured based on a hierarchical criteria typicallyestablished by the state based on recommendations from its ADAP Advisory Committee. Of the five stateswith ADAP waiting lists, two
utilize a medical criteria model for prioritizing clients to join the active clientroll.
32% 41% 17%1% 4% 1%0%10%20%30%40%50%60%70%80%90%100%
ADAP waiting list clients, by Race/Ethnicity, as of September 26, 2012
Non-hispanic Black/African American (32%)Non-hispanic White (41%)Hispanic (17%)Asian (1%)Native Hawaiian/Pacific Islander (0%)American Indian/Alaskan Native (4%)Multi-racial (1%)
67% 32%1%0%10%20%30%40%50%60%70%80%90%100%
ADAP waiting list clients, by Gender, as of September 26, 2012
Male (67%)Female (32%)Transgender (1%)
Factors Leading to Implementation of Cost-containment Measures:
ADAPs reported the following factorscontributing to consideration or implementation of cost containment measures:
Higher demand for ADAP services as a result of increased unemployment (12 ADAPs)
Level federal funding awards (11 ADAPs)
Increased demand for ADAP services due to comprehensive HIV testing efforts (9 ADAPs)
Escalating drug costs (8 ADAPs)
State budget decreases (5 ADAPs)
ADAPs with Active Waiting Lists(104 individuals in 5 states*, as of October 11, 2012)StateNumber of Individualson ADAP Waiting ListPercent of the TotalADAP Waiting ListIncrease/Decreasefrom PreviousReporting PeriodDate WaitingList BeganFlorida
58 56% 36 June 2010
Georgia
0 0% 0 July 2010
Louisiana**
30 29% -26 June 2010
North Carolina
0 0% 0 January 2010
South Dakota
16 15% 6 August 2012
*As a result of FY2012 ADAP emergency funding, Alabama, Florida, Georgia, Idaho, Louisiana, Montana, Nebraska,North Carolina, and Virginia were able to reduce the overall number of individuals on their waiting lists.**Louisiana has a capped enrollment on their program. This number represents their current unmet need.
ADAPs with Capped Enrollment (as of October 11, 2012)State Enrollment CapIdaho
197
Utah
450 direct medication clients,100 insurance clients
Wyoming
135
ADAPs with Other Cost-containment Strategies: Financial Eligibility(instituted since September 2009, as of September 26, 2012)
Since September 2009,
six ADAPs
previously lowered their financial eligibility as part of their cost-containment plans. Illinois, North Dakota, Ohio and South Carolina lowered their eligibility level to 300% FPL. Utah lowered its eligibility level to 250% FPL. Arkansas lowered its eligibility level to 200% FPL.Previously, income eligibility for the states noted above was 400% FPL or higher. As a result of thesemeasures, a total of 445 individuals in three states (Arkansas - 99, Ohio - 257, and Utah
–
89) weredisenrolled. Illinois, North Dakota, and South Carolina grandfathered clients that were previouslyeligible based on their income level into their programs. No other ADAPs currently report anticipatingfurther changes to their financial eligibility.
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