ADAP Watch 1/13/2012

by D Gregory Smith

ADAPs With Waiting Lists
(4,717 individuals in 12 states*, as of January 12, 2012)
State Number of Individuals on ADAP Waiting List Percent of the Total ADAP Waiting List Increase/Decrease From Previous Reporting Period Date Waiting List Began
Alabama 47 1% -44 October 2011
Florida 1,301 28% 135 June 2010
Georgia 1,275 27% -12 July 2010
Idaho 6 0.1% -3 February 2011
Louisiana** 628 13% 27 June 2010
Montana 11 0.2% -2 January 2008
Nebraska 17 0.4% 2 October 2011
North Carolina 126 3% 1 January 2010
Ohio 0 0% 0 July 2010
South Carolina 164 3% 0 March 2010
Utah 32 1% 0 May 2011
Virginia 1,110 24% 7 November 2010
* As a result of FY2011 ADAP emergency funding, Alabama, Florida, Georgia, Idaho, Louisiana, Montana, North Carolina, Ohio, South Carolina, Utah, 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 Other Cost-Containment Strategies: Financial Eligibility
(445 Individuals in 6 States, as of November 9, 2011)
State Lowered Financial Eligibility Disenrolled Clients
Arkansas 500% to 200% FPL 99 clients (September 2009)
Illinois 500% to 300% FPL Grandfathered in current clients from 301-500% FPL
North Dakota 400% to 300% FPL Grandfathered in current clients from 301-400% FPL
Ohio 500% to 300% FPL 257 clients (July 2010)
South Carolina 550% to 300% FPL Grandfathered in current clients from 301-550% FPL
Utah 400% to 250% FPL 89 clients (September 2009)

ADAPs with Other Cost-containment Strategies (instituted since April 1, 2009, as of November 9, 2011)

Alabama: reduced formulary Arizona: reduced formulary Arkansas: reduced formulary Colorado: reduced formulary Florida: reduced formulary, transitioned 5,403 clients to Welvista from February 15 to March 31, 2011 Georgia: reduced formulary, implemented medical criteria, participating in the Alternative Method Demonstration Project Illinois: reduced formulary, instituted monthly expenditure cap ($2,000 per client per month), disenrolled clients not accessing ADAP for 90-days Kentucky: reduced formulary Louisiana: discontinued reimbursement of laboratory assays North Carolina: reduced formulary North Dakota: capped enrollment, instituted annual expenditure cap Ohio: reduced formulary Puerto Rico: reduced formulary Utah: reduced formulary Virginia: reduced formulary, restricted eligibility criteria, transitioned 204 clients onto waiting list Washington: instituted client cost sharing, reduced formulary, only paying insurance premiums for clients currently on antiretrovirals Wyoming: capped enrollment, reduced formulary, instituted client cost sharing

ADAPs Considering New/Additional Cost-containment Measures (before March 31, 2012***)

Alaska: reduce formulary Florida: lower financial eligibility Kentucky: reduce formulary Montana: reduce formulary Oregon: reduce formulary Puerto Rico: reduce formulary Tennessee: establish waiting list Wyoming: establish waiting list, lower financial eligibility, institute client cost sharing

Access to Medications (as of November 9, 2011)

Case management services are being provided to ADAP waiting list clients through ADAP (2 ADAP), Part B (9 ADAPs), contracted agencies (5 ADAPs), and other agencies, including other Parts of Ryan White (4 ADAPs).

For clients on ADAP waiting lists who are currently on or in need of medications, 11 ADAP waiting list states can confirm that ADAP waiting list clients are receiving medications through either pharmaceutical company patient assistance programs (PAPs), Welvista, or other mechanisms available within the state.

***March 31, 2012 is the end of ADAP FY2011. ADAP fiscal years begin April 1 and ends March 31. To receive The ADAP Watch, please e-mail Britten Pund at bpund@NASTAD.org.

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