June 11, 2010

As of June 10, 2010, there were 1,431 individuals on AIDS Drug Assistance Program (ADAP) waiting lists in
eleven states. This is a 116 percent increase from the 662 individuals on the March 2010 ADAP Watch. Twelve
ADAPs, four with current waiting lists, have instituted additional cost-containment measures since April 1, 2009.
In addition, seven ADAPs, including two with current waiting lists, are considering implementing new or
additional cost-containment measures by the end of March 2011. States that have instituted cost containment
measures and those considering them, in addition to implementing waiting lists, are reducing program eligibility,
capping enrollment, reducing the number of drugs on the formulary and cutting other services, all of which
impact access to life saving HIV medications for medically vulnerable individuals.

With continuing cuts in state funding, growing client demand for access to ADAP services and minimal federal
increases, it is paramount that emergency federal resources be made available to stave off the crisis most ADAP
programs and the clients they serve are facing. ADAPs received an increase of $20 million in federal funding in
FY2010, however, this falls far short of what is necessary for ADAPs to clear current waiting lists and maintain
current and newly eligible clients. NASTAD and other community organizations are appealing for an additional
$126 million in FY2010 emergency federal funding to allow states to continue their programs and clear waiting
lists without imposing further access restrictions for people living with HIV/AIDS who need ADAP services.
ADAPs continue to operate efficient and cost effective programs and drug distribution systems as well as
securing the lowest prices on HIV antiretroviral possible. These savings, though significant, do not preclude the
need for additional federal resources to patch the growing gaps in access.

For many states, the programs viability depends on federal funding awards and state general revenue support
for the next state fiscal year (in most states this begins on July 1, 2010). From FY2008 to 2009, ADAPs nationally
experienced an average monthly growth of 1,271 clients. This is an unprecedented increase of 80 percent from
FY2008 when ADAPs experienced an average monthly growth of 706 clients.

ADAPs with Current or Anticipated Cost-Containment Measures, Including Waiting Lists, June 2010

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The following ADAPs reported cost containment strategies. Other ADAPs may need to consider changes but due
to unfinished state budget processes, political factors and other considerations, have not reported them.

ADAPs with Waiting Lists (1,431 individuals, as of June 10, 2010)*

Florida: 113 individuals
Hawaii: 7 individuals
Idaho: 25 individuals
Iowa: 91 individuals
Kentucky: 177 individuals
Montana: 18 individuals
North Carolina: 710 individuals
South Carolina: 145 individuals
South Dakota: 21 individuals
Utah: 104 individuals
Wyoming: 20 individuals

ADAPs with Other Cost-containment Strategies (instituted since April 1, 2009)

Arizona: reduced formulary
Arkansas: reduced formulary, lowered financial eligibility to 200% of FPL
Colorado: reduced formulary
Illinois: reduced formulary
Iowa: reduced formulary
Kentucky: reduced formulary
Louisiana: capped enrollment, discontinued reimbursement of laboratory assays
Missouri: reduced formulary
North Carolina: reduced formulary
North Dakota: capped enrollment, cap on Fuzeon, lowered financial eligibility to 300% FPL
Utah: reduced formulary, lowered financial eligibility to 250% FPL
Washington: client cost sharing, reduced formulary (for uninsured clients only)

ADAPs Considering New/Additional Cost-containment Measures (before March 31, 2011**)

Arizona: waiting list
California: proposed elimination of ADAP services in city and county jails
Florida: reduced formulary, lowered financial eligibility
Illinois: reduced formulary, lowered financial eligibility, monthly expenditure cap
Ohio: reduced formulary, lowered financial eligibility, capped enrollment, client cost sharing, annual and
monthly expenditure caps
Oregon: reduced formulary, client cost sharing, annual expenditure cap
Wyoming: reduced formulary

*Montana, South Dakota, Utah, and Wyoming waiting list numbers are reported as of June 2, 2010
**March 31, 2011 is the end of ADAP FY2010. ADAP fiscal years begin April 1 and end March 31.

About ADAP: ADAPs provide life-saving 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, Guam, the Northern Mariana Islands, the Federated States of Micronesia, American
Samoa, and the Republic of the Marshall Islands. In addition, some ADAPs provide insurance continuation and
Medicare Part B wrap-around services to eligible individuals. Ryan White Part B programs provide necessary
medical and support services to low income, uninsured, and underinsured individuals living with HIV/AIDS in
all states, territories and associated jurisdictions.

NASTAD (www.NASTAD.org) is a nonprofit national association of state health department HIV/AIDS program directors who have programmatic
responsibility for administering HIV/AIDS and viral hepatitis health care, prevention, education, and supportive services programs funded by state
and federal governments. To receive The ADAP Watch, please e-mail Britten Ginsburg at bginsburg@NASTAD.org.