That’s right. From a memo by Judy Nielsen, State HIV Programs Coordinator at Montana Department of Public Health & Human Services:
All persons waiting to be enrolled into Montana ADAP have been authorized for enrollment. As of Tuesday morning, May 15, 2012, the Montana ADAP waiting list is zero.
As of Wednesday morning, however, that wait list again had 1 person- a sign that people are still being infected and still in need of drug assistance. Montana, and 8 other states, have struggled to enroll low-income persons ( 200% of the US Poverty level, currently $22340.00 adjusted gross income) and non-insured HIV-infected persons into the AIDS Drug Assistance Program.
“Wait lists aren’t a bad thing as long as you can assure that everyone is getting medicine- it draws attention to the need”, Nielsen said. “Some states have lowered income eligibility for ADAP, but that just hides the need.”
From NASTAD: Six ADAPs have previously lowered their financial eligibility thresholds as part of their cost-containment plans since September 2009, (disqualifying hundreds of lower income persons). Illinois, North Dakota, Ohio and South Carolina lowered their eligibility level to 300 % FPL. Utah lowered their eligibility level to 250% FPL, and Arkansas lowered their eligibility level to 200% FPL. Previously, all states had FPLs of 400% and above. As a result of these measures, a total of 445 individuals in three states, Arkansas (99), Ohio (257), and Utah (89), were disenrolled. Illinois, North Dakota, and South Carolina grandfathered their clients that fell within the income levels into their programs. No other ADAPs,(including Montana) currently anticipate further changes to their financial eligibility. (Italics and emphasis mine)
“Montana has a high average among all ADAPS in the nation for eligibility”, Nielsen said. “It’s in the lower third of cost-per-client, mostly in our low administration cost and low markup for our drugs- all the antiretrovirals are offered- all. And we have a complete formulary for HIV-related medications. Through compassionate use programs from pharmaceutical companies and other programs, everyone in HIV care in Montana has access to medications. And with the federal dollars released by the Obama administration, I expect to continue to keep the wait list low through the end of the year.”
Montana has had a wait list off and on since 2002, the high mark was 35 persons in 2010. The ADAP program in Montana currently serves 130 persons- not much in the grand scheme of things- but for a low population state, we’re doing a pretty good job of taking care of our people.
We could do even better if all at-risk persons were tested regularly, and if all HIV-infected persons were linked to care. Remember, Treatment is prevention.
But I’m still very proud of the work we’re doing in Montana.