Ohioans lose aid for HIV drugs

[RapidRod]

320 Ohioans lose aid for HIV drugs
Friday, July 2, 2010 02:51 AM
By Misti Crane
THE COLUMBUS DISPATCH   http://www.dispatchpolitics.com/live/content/local_news/stories/2010/07/02/copy/320-ohioans-lose-aid-for-hiv-drugs.html?adsec=politics&sid=101

The Ohio Department of Health cut 320 people from HIV-medication assistance, instituted a waiting list and made other cuts yesterday to a program that serves about 5,000 people who have the virus.
The department projected a deficit of $16.4million by the end of the program's fiscal year on March 31, and it had to slash services, said Jay Carey, management analyst for the state's Ryan White program.
Eligibility is now limited to people with annual incomes at or below 300 percent of the federal poverty level; that puts the threshold at about $32,000 for a single-person household. The level had been 500 percent.
The waiting list means that no one begins getting assistance until someone leaves the program. The $35 million program, supported by a combination of state and federal dollars, no longer will pay for medications that aren't directly related to treating the virus, and it won't provide help for transportation and housing. It will continue to cover anti-retroviral drugs and drugs that prevent infections.
Those losing aid "are very stressed out now, wondering if they're going to get the medication that keeps them alive," said Kevin Sullivan, executive director of the Ohio AIDS Coalition. "To be frank about it, this could be disastrous for individuals and their health care."
Program staff members called clients who were being cut off from funding, and they also are informing others who will remain eligible but lose some services, Carey said. Case managers will continue to work with everyone who needs help finding medications, regardless of their income, he said.
In particular, case managers will help people apply to get their drugs free from the pharmaceutical companies that make them.
The sour economy in recent years has led more HIV-positive Americans to seek help when they lose their insurance or their jobs. About 3,000 additional people have signed up for assistance since the end of 2005, Carey said.
"We've been getting about 100 new clients per month. That's largely what is spurring these changes, is the increase in enrollment and increased program costs," he said.
Since April, 12 other states have made cuts in their programs, according to the National Alliance of State and Territorial AIDS Directors.
As of June 24, 1,840 Americans were on waiting lists.
Community groups, including the Columbus AIDS Task Force, will try to help those affected by the cuts, Sullivan said.
People who adhere to treatment plans are less likely to spread the virus, making the prospect of people dropping their medicine even more concerning, Sullivan said.
And because the state program no longer will pay for medications not directly related to HIV, people will face other challenges, he said. In particular, he's concerned about those with mental illnesses stopping their psychiatric medications and then neglecting the treatment of their HIV.
The good news is that most drugmakers have been generous in providing HIV medicine to those who can't pay for it, Sullivan said.
He said he's hopeful the federal government will rescue the struggling drug-assistance programs with an infusion of money.
mcrane@dispatch.com

[leatherman]

yikes! 
i just heard on Tues that this waiting list was coming; but I hadn't heard about the cuts!

How scary it much be to be poor enough last week to need ADAP to help you have access to HIV meds and be looking at starting next week, after the 4th of July holiday, wondering how you'll be able to come up with $2k a month to get your meds from now on.

Here the brand-new just-issued ADAP Watch (before the latest sad news from OH)
ADAPs with Waiting Lists (2,090 individuals, as of July 1, 2010)
(changes since June 25th)
Florida: 523 (+162)
Hawaii: 10 (+1)
Idaho: 26 (0)
Iowa: 97 (0)
Kentucky: 198 (-9)
Louisiana: 112 (+53)
Montana: 20 (-1)
North Carolina: 783 (+14)
South Carolina: 187 (+12)
South Dakota: 22 (0)
Utah: 112 (0)

already added to this list
Ohio: 320

coming soon
GA: ?
http://www.bilerico.com/2010/06/georgia_begins_adap_wait_list_on_july_1.php
IL:?
http://www.thebody.com/content/art56908.html

the last list from barely over a week ago
June 25, 2010 ADAP Watch
(changes from June 11)
Florida: 361 (+248)
Hawaii: 9 (+2)
Idaho:  26 (+1)
Iowa: 97 (-6)
Kentucky: 189 (-12)
Louisiana: 59 (+59)**
Montana: 21 (+3)
North Carolina:  769 (+59)
South Carolina: 175 (+30)
South Dakota: 22 (+1)
Utah: 112 (+8)
Wyoming: 0 (-20)*

These lists are starting and growing so fast, it's getting hard to track them as the ADAP Watch is coming out nearly every two weeks now updating this crisis. We almost need an ADAP Crisis forum to keep track of the changes and to discuss actions we can take to help try to reverse these growing lists.

[wtfimpoz]

Forgive me for my lack of background knowledge about the subject, im new...

isn't it more practical to use the new "pre existing condition" insurance pools to care for HIV positive individuals, with ADAP funds being distributed to fund the $900/month premiums?  It seems a lot cheaper than the cost of directly providing treatment.

[leatherman]

isn't it more practical to use the new "pre existing condition" insurance pools to care for HIV positive individuals

in a way similar to what you suggest, for several years while I lived in OH, OH ADAP paid my monthly SS premium allowing me to immediately qualify each month to get the OH medicaid care which then covered my prescriptions. (But whether it was OH ADAP or OH Medicaid, technically it was still OH that covered the expense for my meds with state and federal funds. this way just took the burden off the ADAP program and transfered it to the larger medicaid budget)

but right now, OH hasn't actually gotten the final approval or started their high-risk program yet.

"Cleveland Plain Dealer: "Health coverage could be a step closer in Ohio for more than 5,000 people whose pre-existing medical conditions or diseases made insurance unavailable or highly unaffordable. ... The Ohio Department of Insurance announced Friday it has picked Medical Mutual of Ohio to run the temporary program, called a high-risk insurance pool. Assuming approval by the U.S. Department of Health and Human Services, the program will start in August, a state insurance department spokeswoman said, and run until 2014, when broader federal health reforms kick in"
http://www.kaiserhealthnews.org/Daily-Reports/2010/June/27/health-insurance.aspx

[WillyWump]

This is ballooning out of control, and im not sure where it will end.

What is pissing me off even more is according to the article on the home page Obama has been directly asked for funds to clear the list, both times it received no response.

Come on Obama! You're starting to wear on my nerves you idiot! What happened to "Yes we can"? oh, thats right when it comes to ADAP issues it's "No Way we wont"!! Jesus, even Bush found emergency funds!!

grrrrrrr!

http://www.poz.com/articles/exclusive_adap_crisis_401_18672.shtml


Let’s talk about the federal government’s response. Last time there was an ADAP crisis in 2006, President Bush found emergency funds. This time, there’s been a lot of discussion and steps taken to try to remedy the situation, but so far, no additional funding has been given. A few months ago, about 80 members of the U.S. House of Representatives signed a petition asking Obama for $126 million for ADAPs, but it got no response. Then two GOP senators introduced a bill seeking to take the $126 million from stimulus funds, but no Democrats signed on. Is the lack of additional ADAP funding a result of partisan politics

-Will

[wtfimpoz]

Refuses to support gay marriage.  Drags his feet on campaign promises to eliminate don't ask/don't tell.  Now this.  If there was ever a democrat who would make gay men vote republican in droves just to spite him, its Obama.  Its not "yes we can" versus "no we can't".  Its always been "yes we can" turning into "no we won't" with him.

[BlueMoon]

I'm pretty sure I'm one of the 320 Chosen Ones who will recieve a letter or phone call in the next few days. 

I'm enrolled in a program that pays my meds copays.  For the last few months I've been getting my meds through another channel because "oh, we have the money, we just can't use it until July 1."  I didn't really understand but the mailman kept bringing meds to my house so it was no problem. 

As the big day of July 1 approached, I'd heard nothing from OHDAP or my case manager about reverting to the usual program, so I contacted her the other day and was told that it was taking "longer than expected" to get the program "back up and running".  I was told I would probably continue another month in the alternate program.  It appears now that she was blowing smoke. 

Change is coming fast now.  Dropping the boosted Reyataz from my regimen would save almost $740 every three months.  I think it may be redundant anyway but my HIV doc is reluctant to drop it.  Obama may have made the decision for me!   

[newt]

For the richest, freest county in the world, this is a constitutional shame :-(

[wtfimpoz]

Change is coming fast now.  Dropping the boosted Reyataz from my regimen would save almost $740 every three months.  I think it may be redundant anyway but my HIV doc is reluctant to drop it.  Obama may have made the decision for me!   

Dropping necessary medication from your regime?  Wow, thats "change we can believe in".  I'm very sorry for you.  What do your copays noramlly come to for the meds?

[Inchlingblue]

Forgive me for my lack of background knowledge about the subject, im new...

isn't it more practical to use the new "pre existing condition" insurance pools to care for HIV positive individuals, with ADAP funds being distributed to fund the $900/month premiums?  It seems a lot cheaper than the cost of directly providing treatment.

That's a great idea. I wonder if it will be do-able. And it would be full and comprehensive insurance not just meds and labs which is what ADAP covers.

The premiums would actually be less for those younger, say in their 20s, since they are based on age. So the average premium costs would likely be less than $900.

I had read there is a 6 month waiting period to get these policies after showing rejection from a regular insurance policy (which is a ridiculous provision) but one of the latest articles that came out did not mention this waiting period and in fact said people who apply now can be covered very soon (in like a couple months).

For the richest, freest county in the world, this is a constitutional shame :-(

True that.

[aztecan]

Forgive me for my lack of background knowledge about the subject, im new...

isn't it more practical to use the new "pre existing condition" insurance pools to care for HIV positive individuals, with ADAP funds being distributed to fund the $900/month premiums?  It seems a lot cheaper than the cost of directly providing treatment.

That is a good idea and a workable solution. Here in New Mexico, we have the New Mexico Medical Insurance Pool, or MIP as we call it. It is for those who have a medical condition that qualifies them. HIV is one, but there is quite a litany.

The ASOs here enroll you in the MIP as soon as your enrollment in the ASO is finalized. ADAP is used only temporarily until the MIP kicks in. The ASO pays the premiums from its funding, some of which is Ryan White, some from other sources.

The bottom line is the person gets full medical insurance, not just prescription coverage. The HIV meds and other meds on the state formulary are shipped by UPS to the person without copay. If the person goes to a pharmacy to get something not on the formulary, they he/she pays a copay.

People also pay copays when the see the doctor, etc.  But, if the person wants/needs to see a specialist, has to go to the E.R., or to urgent care, he/she would be covered because it is full insurance.

In the long run, while the individual does have to pick up some of the tab through copays, it is still a better deal, I think and is what I consider the best bang for the dollar.

Now that I've gone on ad nausem regarding this, Roddles hon, is this going to affect you?

HUGS,

Mark

[camille07]

For the richest, freest county in the world, this is a constitutional shame :-(

What does that mean anymore? I'm not in any way debating this statement newt, I'm  just extrapolating from my own thoughts for a new query.  I have state assistance for my meds but I know someone from Carolina who is on the waiting list?  They have diabetes and need new medications.   They are desperate.
A woman in jersey...according the app.com is battling cancer and discussing about paying for health insurance with unemployment which runs out this week. She can't afford her electric ...is that free?   Not having a home because you fell into the arm mortgage and literally live in a shanty home, and a old poz'r,  is that free?  This country needs real change and not in a sophomoric, idealic means of change but something that stings for a long while.

But as for Jersey and my adap, I am new to  this and I'm going on my 4.5 years.  I am damn grateful that I received what I have because I 'm not on a waiting.

[BlueMoon]

Dropping necessary medication from your regime?  Wow, thats "change we can believe in".  I'm very sorry for you.  What do your copays noramlly come to for the meds?

Currently it's almost $1900 for a ninety-day supply, plus a $400 annual deductible.  I'm also in a program that pays my insurance premiums, so if this news article means what I think it does, I've lost $1000 a month in HIV assistance.  I will be looking for 'change' under the couch cushions after guests leave!

The kicker is that if I lose my job (shakey due to ongoing economic blight) then I will have to go to the back of the waiting list to get back on ADAP.

[wtfimpoz]

Currently it's almost $1900 for a ninety-day supply, plus a $400 annual deductible.  I'm also in a program that pays my insurance premiums, so if this news article means what I think it does, I've lost $1000 a month in HIV assistance.  I will be looking for 'change' under the couch cushions after guests leave!

The kicker is that if I lose my job (shakey due to ongoing economic blight) then I will have to go to the back of the waiting list to get back on ADAP.

Six hundred and thirty three dollars a month for medical copays?  What kind of insurance are you on, if i may ask?  I've been terrified of copay issues, but in my wildest nightmares, I haven't anticipated anything as absurd as that. 

[Inchlingblue]

Six hundred and thirty three dollars a month for medical copays?  What kind of insurance are you on, if i may ask?  I've been terrified of copay issues, but in my wildest nightmares, I haven't anticipated anything as absurd as that. 

There is help with co-pays:

http://forums.poz.com/index.php?topic=33369.0

[MitchMiller]

What I don't understand is the cost of the HIV generics in the US is still a LOT higher than HIV generics purchased directly from India.  I pay less than $250/month for my entire regimen from India.  I look online (drugstore.com) at the price of, for example, abacavir whose patent has expired, and see it is nearly FIVE times the price I pay. 

Why?   These are the questions our local governments should be asking.

[mecch]

Eek.
Listen, if someone is in a bind and needs Intelence, contact me.   

[BlueMoon]

Still no official word from OHDAP or my case manager.  They should have had letters to clients in the mail before making the public announcement.  Maybe they're hoping I'll just forget about it.   

I'll leave email and phone messages with my case manager tomorrow morning.  It would be nice to know where next month's meds are coming from.

[Inchlingblue]

I just heard a story about the ADAP funding issues on NPR, it seems at least this is getting lots of publicity, which is likely to help

[BlueMoon]

Wait, there's more!  Not only did they reduce the income qualification, but have now added medical qualifications and reduced the formulary.   

An additional 500 people are about to be cut off from a program that pays for their HIV medications, prompting concern that more Ohioans will go without the drugs that keep them healthy and lower the risk they’ll transmit the virus to others.

The state is nailing down details for a plan to offer help only to the sickest HIV patients, said Jay Carey, management analyst for the Ryan White Program, administered by the Ohio Department of Health.

The plan is to limit eligibility either to those with a CD4 count of 500 or below or to those whose count has dropped below 200 at any point. The count is a measure of a type of white blood cell and is used to gauge immune-system health.

Carey anticipates the change will occur next month and save the program about $2.9 million a year.

Earlier this month, 250 people were dropped from the program when leaders decided that only those at or below 300 percent of the federal poverty level — about $32,000 for a single person — could get help. Before, someone could make up to 500 percent of the poverty level.

The department also instituted a wait list and stopped paying for other things, including non-emergency dental care and medications for problems not directly related to HIV. The wait list stands at 19 people, and 30 more have applied.

Link to article

[unclespongebob]

i thank my lucky stars that i have ins. through my work that helps with my meds . but what about the people that dont have any insurance to help that . they depend on the goverment to help to get med , and our goverment says that tey dont care aout them

[randym431]

For the richest, freest county in the world, this is a constitutional shame :-(

Rich and free doesn't mean much anymore.
Rich decide who is to remain rich, and the free decide who should have freedom.

The real question is a countries moral decency. How they treat the sick, poor and those in need.
In that area, money and power and bigotry trump decency time after time.
No.. its typical and not shocking what has been happening...

[randym431]

And as to Obama...
I don't get this liberal label fear we have had with the last two democratic presidents.
It started with Clinton, pandering to the right, and continues now with Obama.
Hell.. if I wanted a republican in office, I'd voted republican.

[Inchlingblue]

More cuts in O-HI-O:

COLUMBUS (AP) -- The state plans to drop an extra 500 Ohioans from a program that pays for their HIV medications, in order to save Ohio almost $3 million per year.

Continued . . .

LINK:

http://www.lancastereaglegazette.com/article/20100726/NEWS01/7260312/1002/OHIO-TO-CUT-HIV-DRUG-PROGRAM-TO-TRIM-SPENDING

[WillyWump]

More cuts in O-HI-O:

COLUMBUS (AP) -- The state plans to drop an extra 500 Ohioans from a program that pays for their HIV medications, in order to save Ohio almost $3 million per year.

Continued . . .

LINK:

http://www.lancastereaglegazette.com/article/20100726/NEWS01/7260312/1002/OHIO-TO-CUT-HIV-DRUG-PROGRAM-TO-TRIM-SPENDING

From your link..

"to help only the sickest Ohioans with HIV pay for their medicine"

"The new cuts propose to limit eligibility based on a count that measures a type of white blood cell"

I'm flabergasted at this reasoning. For the sake of argument let's say the eligibility is 300CD4 or less, we all know that it is a matter of time before those denied HAARt will drop to the "eligible count", some in a matter of a month or so. So over the span of a few months Ohio will be right back where they started...with a waiting list. Except this time the people waiting will be sicker and potentially will be incurring large ER bills of which the state will have to pay a portion of.

This assinine reasoning reminds me of the boy who sticks his thumb into the leaky dam in an effort to stem the flow. Except in this case Ohio is screwing with peoples lives.

We need emergency federal intervention, and we need it now.

-Will

[Inchlingblue]

This assinine reasoning reminds me of the boy who sticks his thumb into the leaky dam in an effort to stem the flow. Except in this case Ohio is screwing with peoples lives.
 

I mentioned either here or in another thread that I think the people who make these decisions are not aware of the basic science of HIV. There's no other way to explain their reasoning.

Pretty much everyone with HIV will get sick eventually except for elite controllers. Depriving people of meds will cost them more in the long run with emergency room expenses.

[Hellraiser]

Ri-Goddamn-diculous.

[veritas]

Inch,

I believe they know the basic science (they certainly have access to experts to explain it to them). This issue is just going to get worse and worse. The cost of these medications are just not sustainable. Which group politically can they get away with doing something like that? Think about it.
WillyWump is correct, they know they are screwing with peoples lives. They know people will get sick as cd4s fall. The money saved from the program can be funneled to other more politically appropriate places.  This action in Ohio is only the beginning. Watch it spread!

v

[hope_for_a_cure]

This not only pisses me off but brings home a real truth about our Government.  ALL politicians will pretty much say ANYTHING to win an election, Obama included.  Our founding fathers actually would turn over in their graves if they could see what politics has turned into.  The super conservatives as well as supposedly liberal democrats are ONLY concerned about one thing... their political career(s).  Yea, we can vote them out but when they are replaced its just 'more of the same'.   MOTS!  MOTS!  MOTS! 

Do you really think that all the tax money spent on 'nation building' is appreciated by the recipients?  The answer is F-NO!  It would only take a fraction of that to help the people here in this country gain access to medications needed to live.  Its not like we are asking the government to build us new cities and provide additional 'police efforts' to our streets.  Dont get me started....... UUUUGGGGHHHHH!!!

[RapidRod]

This not only pisses me off but brings home a real truth about our Government.  ALL politicians will pretty much say ANYTHING to win an election, Obama included.  Our founding fathers actually would turn over in their graves if they could see what politics has turned into.  The super conservatives as well as supposedly liberal democrats are ONLY concerned about one thing... their political career(s).  Yea, we can vote them out but when they are replaced its just 'more of the same'.   MOTS!  MOTS!  MOTS! 

Do you really think that all the tax money spent on 'nation building' is appreciated by the recipients?  The answer is F-NO!  It would only take a fraction of that to help the people here in this country gain access to medications needed to live.  Its not like we are asking the government to build us new cities and provide additional 'police efforts' to our streets.  Dont get me started....... UUUUGGGGHHHHH!!!

I know Ohio is broke and this is just going to be a drop in the bucket in the upcoming years. just watch. We got the change alright, short changed.

[metekrop]

This is really frustrating.  No doubt that it will be knocking at each one of us’ door.

But I am wondering why the government makes the HIV treatment free like TB, Malaria and other similar diseases.  Is it not epidemic that needs to be controlled?

[mecch]

The super conservatives as well as supposedly liberal democrats are ONLY concerned about one thing... their political career(s).  Yea, we can vote them out but when they are replaced its just 'more of the same'.   MOTS!  MOTS!  MOTS!  

Cest pas si grave que ca!  I think that all politicians are not so black and white selfishly cynical to think ONLY of their careers. For example, Obama may think of what he can accomplish in 8 years as opposed to 2 (mid-term elections and prospect of losing congress), and thinking about re-electability by any politician, and acting with that in mind, can come IN TANDEM with the policy points they would like to make - politicians make compromises considering all of it together.