ADAP Watch 7.19.12


The Administration has pledged new money to end the waiting lists, but they will linger for some time. Making sure that everyone who needs ART drugs can get them is an obvious first step towards ending this country’s HIV/AIDS epidemic, but when the waiting lists are gone, we’ll have to move on to the hard work of changing attitudes towards people with HIV and ensuring access to health care for all Americans, not just those living with HIV.

It was grimly entertaining, explaining to Conference delegates from Canada and Germany what ADAP is and why we have waiting lists, when it’s so obviously better public health policy and so obviously more fiscally prudent to treat everyone with HIV who wants treatment. After she got past her initial disbelief, a German delegate gently suggested that there are better ways to handle this sort of thing. We wouldn’t need ADAPs, let alone have ADAP waiting lists, if we had a rationally designed national health care system.

Here are the latest numbers from our friends at NASTAD:

ADAP Watch March 12, 2012

From our friends at NAPWA:


The President has called for The End of AIDS in America, and that means an end to ADAP waiting lists. Everyone who needs HIV antiretroviral medicines should be getting them, and we can reduce long-term health care costs by making sure they do.
This is an extraordinarily difficult political climate, though, so we don’t expect much movement on the waiting lists until after the elections. We’re grateful to the Administration for the new money that brought the counts down from 9,000-plus to just under 4,000, and we think it’s time for states like Virginia and Georgia to join the Administration and pay their fair share. Belly up to the bar, boys!
Here are the latest waiting list numbers from our friends at NASTAD. Let’s not forget that these are the visible waiting lists. Too many states have vanished PLWHA who used to qualify for ADAP assistance by setting income eligibility ceilings unreasonably low.

ADAP Waiting List 1/26/12

ADAP Watch 1/13/2012

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

AIDS Drug Assistance Program Numbers, 11/03/11


From The NAPWA Positive Voice Newsletter:

The waiting lists numbers keep coming down – a little. The federal government released $1.8 billion to support federal-state HIV partnerships, with $813 million earmarked specifically for ADAP programs with waiting lists.

The release of funds is slow, though, and the four states that account for almost the entire waiting list – Florida, Georgia, Virginia, and Louisiana – aren’t stepping up to the plate to match the additional federal money.

The waiting list states say they can’t afford it. We visited Florida’s ADAP debate in the October 24 Positive Voice. Let’s turn in this issue to Georgia.

Georgia Public Broadcasting reports the state’s waiting list numbers have fallen by about 300, from roughly 1,700 to 1,400, with $3 million in new federal funds. Eliminating the waiting list altogether, state officials say, would cost $15 million the state doesn’t have.

Time for a reality check….

Georgia’s proposed 2012 budget is $20 billion. The $15 million that would eliminate the waiting list amounts to 0.075% – less than one-tenth of one percent – of that budget. Even in a period of state financial stress, with an expected five percent deficit, the needed $15 million is so minuscule that spending it or not spending it to end the waiting list has no material impact on the state’s budget crisis. But Georgia’s political conversation continues to be dominated by proposals to lower higher-income and corporate tax rates and “pay” for the cuts by cutting services and shifting tax burdens to middle and lower-income Georgians.

Georgia’s $15 million we can’t is really a $15 million we don’t want to. And the future cost of this year’s $15 million we don’t want to will be a lot more than $15 million.

Here are the latest waiting list numbers from our friends at NASTAD:


I spent the weekend with 30 HIV+ Gay men in the mountains outside of Helena, Montana. They ranged in age from their early twenties to their mid sixties. It was like every other gathering of gay men in many respects- with one exception: we talked a lot about our health- and our medications.

Mostly about the reliability of receiving these life-saving meds.

It creates a lot of stress for us. The meds are expensive, they have side-effects, they are sometimes mailed from pharmacies with in a day or two of our running out. It often requires us to hound our caseworkers to get what we need- every month, in some cases.

As in most cases with issues of efficiency, increased funding will help. But Congress always needs to be hounded in order to give the HIV+ the kind of funding we actually need. The kind of funding that other medically disabled get almost automatically.

We don’t even have enough money to take care of those waiting to be admitted to government programs that people already qualify for.

Thus The Waiting List for the AIDS Drug Assistance Program. It needs to end- and you can help. Click the link below the map.


ADAP Watch, 9.12.11

From NAPWA’s Positive Voice Newsletter:

We’re beginning to think we’re trapped in the movie Groundhog Day.


Week after week, the waiting list numbers hover just over 9,000. Week after week, Congress doesn’t – and can’t – act. Week after week, Florida alone accounts for nearly half the waiting list numbers, and Florida doesn’t act.


Assuming an annual medications cost of $15,000 per ADAP recipient per year, $135 million a year in new ADAP funds would be enough to make this national disgrace go away. That’s less than four one-thousandths of a percent of the federal budget. If the will were there, the money could be found.


$60 million would do the job in Florida – not very much, even in Florida’s $70 billion state budget. But Florida doesn’t even seem to be spending the money already available effectively. Just before Labor Day, the Orlando Sentinel reported health officials for Orlando County and three neighboring central Florida counties had underspent their Ryan White funds by a half-million dollars – about six percent of the total $9 million, which suggests a certain lack of commitment to serving the people Ryan White funds are meant to help. And it’s a pity the unused funds couldn’t have been put to other uses, instead of just being help for possible use next year. They could have paid for drugs for more than thirty central Floridians currently on the ADAP waiting list.


Here are the latest waiting list numbers from our friends at NASTAD:

Sign the petition to end the waiting list here.


ADAP Waiting List Passes 9,000

As of August 4th – and for the first time ever – the number of people lingering on AIDS Drug Assistance Program wait lists passed 9,000. A total of 9,039 people in 13 states are now unable to access their medications via the programs, which provide drugs to under and un-insured individuals who are not eligible for other programs such as Medicaid. What’s more, Alabama, which already had a wait list, has reduced its program’s formulary, while Illinois, which already had expenditure caps, has lowered its program’s financial eligibility to 300% the Federal Poverty Level. This brings the total number of states that have enacted “cost-containment” measures to eighteen, plus Puerto Rico.

For more information on the nation’s ADAP crisis, visit