Florida starts waiting list for AIDS drug program
May 21, 2010
After fighting off the prospect for a decade, Florida will be forced to start a waiting list for a program that pays for costly, life-saving drugs needed by uninsured HIV/AIDS patients, officials said Friday.
The number of HIV-positive patients applying to the $93 million AIDS Drugs Assistance Program (ADAP) has jumped as people lost jobs and health insurance, but squeezed state and federal budgets can't keep up with the demand, officials said.
The state Department of Health will start a waiting list for the program on June 1, will reduce the number of covered drugs in the program on Aug. 1, and will study other cuts, said Tom Liberti, chief of the department's HIV/AIDS bureau.
"This is terrible news," said Michael Rajner, a Fort Lauderdale AIDS activist and member of a department advisory panel. "We rely on the program for help with the drugs that keep us alive. Without it, I don't know what people would do."
The impact of the waiting list is expected to be felt first and hardest in South Florida, a national epicenter of HIV/AIDS where 50,000 people live with the virus. More than half of 18,000 Floridians now enrolled in the program — and more than half of about 300 who enroll every month — live in South Florida.
As of June 1, those who sign up but land on the waiting list would not be able to get coverage for their drugs — often costing thousands of dollars per month — unless someone else left the program. They would have to find another assistance, pay for their drugs out of pocket or do without.
"We've had close to a 25 percent increase in [ADAP] patients in the past two years," Liberti said. "We were successful for 14 years [avoiding a waiting list]. It's hard for all of us to do this."
To be eligible for the program, HIV patients must be uninsured and have incomes of less than four times the federal poverty level — $43,320 for an individual, $58,280 for a family of two.
This is the second waiting list for HIV/AIDS programs that Florida has been forced to start. About 260 are waiting to join the smaller AIDS Insurance Continuation Program that aims to hold taxpayer costs down by paying to keep HIV patients covered with insurance when they can no longer pay the premiums.
Ten other states have had drug waiting lists going back years, with more than 1,000 now waiting. A half-dozen other states are considering waiting lists. The first patient in the nation to die while on a waiting list was noted this year, in South Carolina.
But Florida becomes the largest state with a waiting list and the impact here could be bigger.
Part of the program's money shortfall stems from the state cutting its contribution, from $10.5 million a year as of mid-2008 to $9.5 million now, Rajner said.
"The state Legislature has been negligent in not keeping up with its investment to mirror the epidemic and the need," Rajner said.
Liberti said the state hopes to get extra dollars for the program if the White House approves a special $126 million ADAP grant requested by 76 members of Congress.
In the meantime, Liberti said the state will drop coverage for some secondary HIV drugs, not including crucial anti-virals.
Other possible cuts being studied: dropping moderate-income people from the program, dropping patients with low HIV viral levels, diverting money from other services, and making patients cover part of their drug costs.
For information on the drug program, go to http://www.doh.state.fl.us or 850-245-4444.