ADAP Watch list August 19th 2013

ADAP Watch August 19, 2013

As of August 15, 2013, there were 163 individuals on AIDS Drug Assistance Program (ADAP) waiting lists in three (3) states.  Twelve ADAPs, including three with current waiting lists, have had cost-containment measures in place since April 1, 2013 (reported as of August 6, 2013). Four ADAPs reported considering implementing new or additional cost-containment measures by the end of ADAP’s current fiscal year (March 31, 2014). Previous ADAP Watches ADAP Alert: ADAP Crisis Task Force Announces New Drug Pricing Agreement - July 29, 2013 ADAP Watch - July 22, 2013: 31 on Wait Lists ADAP Watch - June 20, 2013: 227 on Wait Lists ADAPs with Current or Anticipated Cost-Containment Measures, Including Waiting Lists, as of August 6, 2013 ADAPs with Waiting Lists (163 individuals in 3 states, as of August 15, 2013)   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 143 88% +132 June 2010 Idaho 0 0% 0 October 2012 South Dakota 20 12% 0 August 2012 Note: ADAPs are required to recertify all enrolled clients at least twice a year.  This process often creates limited slots below their enrollment cap.  ADAPs often will not eliminate their waiting list until they are able to increase or remove the enrollment cap entirely. Factors Leading to ADAPs Considering or Implementing Cost-containment Measures (36 ADAPs reporting)   Latest ADAP News   The Senate Appropriations Committee passed their version of the FY2014 Labor-HHS-Education Appropriations bill in July.  The bill includes funding for HIV, STD and viral hepatitis programs.  This bill assumes that sequestration will not take place in FY2014, although there is currently no legislation that would eliminate the possibility of sequestration. The House Appropriations Subcommittee did not take up a Labor-HHS-Education Appropriations bill prior to the summer recess. The Senate’s FY2014 budget includes an increase of $2 million over FY2012 for a total of $2.39 billion for the Ryan White Program, which includes a $10 million increase for the AIDS Drug Assistance Program (ADAP). Additionally, this total includes the President’s 2011 World AIDS Day ADAP emergency relief funding (ERF) of $35 million. The Ryan White Part B base FY2014 funding was reduced by $1.5 million from FY2012 levels. The President’s FY2014 budget request included an increase of $10 million for ADAP and it flat funded the Part B base from FY2012. The FY2013 ERF funds will be awarded to ADAPs later this summer.  The FY2013 ERF funds consist of$65 million dollars in competing continuation funds for existing ERF grantees and $10 million in new competing funds available to ADAPs not previously receiving ERF.  The budget period for these FY2013 ERF funds will be six months (through March 31, 2014) to allow  future alignment of the FY2014 ADAP ERF (if funds are available) and FY2014 Part B base/ADAP earmark awards. Waiting List Client Demographics Waiting List Organization: Waiting list clients are prioritized by one of two models: First-come, first-served model:  placing individuals on the waiting list in order of receipt of a completed application and eligibility confirmation (3 ADAPs). Medical criteria model:  based on hierarchical medical criteria based on recommendations by the ADAP Advisory Committee (0 ADAPs).  Access to Medications: All three ADAPs with waiting lists confirm that case management services assist clients in obtaining medications through the HarborPath ADAP waiting list program or pharmaceutical company patient assistance programs (PAPs) while clients are on the waiting list.   ADAPs with Other Cost-containment Strategies (since April 1, 2013i, as of August 6, 2013) Enrollment Cap Expenditure Cap Financial Eligibility Formulary Reduction Other Alabama Idaho Indiana Utah Illinois: (monthly) New Mexico:  (monthly) South Dakota:  (annual) Illinois Alabama Alaska Illinois Louisiana Maine Georgia: cap on insurance premiums Montana:   service reductions in place iADAPs may have other cost-containment strategies that were instituted prior to April 1, 2013.  ADAPs Considering New/Additional Cost-containment Measures (before March 31, 2014ii) Expenditure Cap Waiting List Other Arizona: (annual) Arkansas Utah Wisconsin iiMarch 31, 2014 is the end of ADAP FY2013. ADAP fiscal years begin April 1 and end March 31. ADAPs that Eliminated/Modified Cost-containment Measures (since April 1, 2013iii) Other Washington: stopped requiring use of PAPs during insurance enrollment