Wednesday, August 21, 2013

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).

ADAPs with Current or Anticipated Cost-Containment Measures, Including Waiting Lists, as of August 6, 2013

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)
Number of Individuals on ADAP Waiting List
Percent of the Total
ADAP Waiting List
Increase/Decrease from Previous Reporting Period
Date Waiting List Began
June 2010
October 2012
South Dakota
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)
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 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
Illinois: (monthly)
New Mexico:  (monthly)
South Dakota:  (annual)
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, 2014

Expenditure Cap
Waiting List
Arizona: (annual)

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

Washington: stopped requiring use of PAPs during insurance enrollment

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