As of November 14, 2013, there were 11 individuals on AIDS Drug Assistance Program (ADAP) waiting list in one (1) state.

ADAP Watch

November 18, 2013
As of November 14, 2013, there were 11 individuals on AIDS Drug Assistance Program (ADAP) waiting list in one (1) state. 
  • Ten ADAPs, including one with current waiting list, have had cost-containment measures in place since April 1, 2013 (reported as of August 6, 2013).
  • No ADAPs reported considering implementing new or additional cost-containment measures by the end of ADAP’s current fiscal year (March 31, 2014).
  • Four ADAPs reported modify or eliminating existing cost-containment measures since August 6, 2013.

ADAPs with Current or Anticipated Cost-Containment Measures, Including Waiting Lists, as of November 12, 2013

ADAPs with Current or Anticipated Cost-Containment Measures, Including Waiting Lists, as of November 12, 2013


ADAPs with Waiting Lists
(11 individuals in 1 states, as of November 14, 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

South Dakota

11

100%

-4

August 2012


Note: Alabama and Idaho eliminated their wait lists prior to November 14, 2013 due to the recent receipt of ADAP Emergency Relief Funding (ERF).


Factors Leading to ADAPs Considering or Implementing Cost-containment Measures (41 ADAPs reporting)

Factors Leading to ADAPs Considering or Implementing Cost-containment Measures (41 ADAPs reporting)
 

Latest ADAP News
 
The federal government is currently funded under a FY2014 continuing resolution (CR). This CR funds the federal government at FY2013 post-sequestration spending levels through January 15, 2014.  Both the House and the Senate have agreed to reconcile their budget resolutions in committee and report on their progress by December 13, 2013. Further, unless Congress provides an alternative to the sequester put in place under the 2011 Budget Control Act, agencies can expect a new round of cuts beginning January 15, 2014. 
 
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 is six months (through March 31, 2014) to allow future alignment of the FY2014 Part B base/ADAP earmark awards and the FY2014 ADAP ERF.  HRSA has released both funding opportunities announcements (FOAs).  The FY2014 ADAP ERF application is due November 25, 2013.  The FY2014 Part B base/ADAP earmark application is due on December 9, 2013. 
 
Health departments should continue to expect delays and partial awards across programs, including ADAPs, as “regular order” of the appropriations and budget cycle remains in flux.   


Waiting List Client Demographics

ADAP waiting list clients as of November 12, 2013
 
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 (1 ADAP).
  • Medical criteria model:  based on hierarchical medical criteria based on recommendations by the ADAP Advisory Committee (0 ADAPs). 
Access to Medications: One ADAP 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 November 12, 2013)

Enrollment Cap

Expenditure Cap

Financial Eligibility

Formulary Reduction

Other

Indiana
Utah
Illinois: (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 that Eliminated/Modified Cost-containment Measures
(since April 1, 2013
ii as of November 12, 2013)

Enrollment Cap

Expenditure Cap

Other

Alabama
Idaho

New Mexico

Oklahoma: increase financial
eligibility to 400% for individuals
with insurance; 200% for uninsured.
Washington: stopped requiring
use of PAPs during insurance enrollment


iiADAPs may have other cost-containment strategies that were eliminated/modified prior to
April 1, 2013.
 


About ADAP: ADAPs provide life-saving HIV treatments through directly purchasing medications or providing insurance coverage and wrap-around services to low income, uninsured, and underinsured individuals living with HIV/AIDS in all states, territories and associated jurisdictions.

About PAPs: Uninsured or underinsured individuals living with HIV who are ineligible for ADAPs can access needed medications using the common patient assistance program (PAP) application form to apply for multiple PAPs. To see additional information on pharmaceutical company patient assistance or co-payment assistance programs, please visit the Positively Aware website or the Fair Pricing Coalition's website. In addition, the HarborPath program is available to serve individuals on ADAP waiting lists as well as individuals in select states (see the HarborPath website for more information). 

About NASTAD: NASTAD strengthens state and territory-based leadership, expertise, and advocacy and brings them to bear on reducing the incidence of HIV and viral hepatitis and on providing care and support to all who live with HIV and viral hepatitis. NASTAD’s vision is a world free of HIV/AIDS and viral hepatitis. For more information, visit www.NASTAD.org. To receive or unsubscribe from The ADAP Watch, please contact Christopher Cannon.

like us on Facebook | follow us on Twitter | view us on YouTube | read our Blog | forward to a friend 

Copyright © 2013 NASTAD, All rights reserved.