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Author Topic: Update on NC's ADAP Situation  (Read 1830 times)

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Offline David_CA

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  • Posts: 3,246
  • Joined: March 2006
Update on NC's ADAP Situation
« on: July 12, 2010, 01:09:11 PM »
A couple of weeks ago, I learned of NC's waiting list for ADAP funding.  I emailed Governor Perdue to ask what was being done about it.  Today, I received an email update of the situation.  Below is part of that response.

Quote
I agree with you completely that ADAP truly does provide for life-saving medications, and it was one of Governor Perdueís highest priorities as we moved through this yearís budget process, even at a time when the state faced unprecedented fiscal challenges. I am very happy to tell you that, with her recommendation and the support of the General Assembly, we received a $14 million increase in state funding for ADAP. This will permit the program to continue to serve those already enrolled, and to reopen, effective today, to those people on that waiting list at 125% of the federal poverty level (FPL) (nearly 77% of the current waiting list). Once those people have been processed through the ADAP system, I anticipate that we will continue to serve new clients at 125% FPL. This will allow us to serve the neediest people and those with the fewest resources.
 
I regret that we cannot serve everyone with the funds available, but the fiscal challenges both here and across the country do not make that possible. Those who are above 125% will continue to be eligible for their medications through the various Pharmaceutical Assistance Programs. North Carolina now contributes a full 50% of the stateís ADAP budget; the federal government provides the remaining half.  We are one of the few states to provide this level of support with state appropriations.

I also anticipate that we will be able to re-open the SPAP program for those clients who are dually eligible for ADAP at 125% and Medicare, which allow them a larger range of services and allow us to serve more people than would otherwise be possible.

I'm sure this is not enough to cover everybody, and that 125% FPL really sucks (currently, that's $13,538 for a 'family unit' of 1). 
Black Friday 03-03-2006
03-23-06 CD4 359 @27.4% VL 75,938
06-01-06 CD4 462 @24.3% VL > 100,000
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01-10-11 CD4 908 @36.3%
05-23-11 CD4 846 @36.8% VL 80
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Offline GSOgymrat

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  • HIV+ since 1993. INTJ
Re: Update on NC's ADAP Situation
« Reply #1 on: July 12, 2010, 01:27:29 PM »
Nice that the powers that be are not completely ignoring the situation but it is obviously inadequate.  I want to learn more about the qualifications for NC Medicaid. I see people who obviously should be on Medicaid who aren't and then other people who have Medicaid who seem to have financial resources. For example, I don't understand how adults can have Medicaid and private health insurance, when that health insurance is not a Medicare replacement policy. In the US we have this patchwork healthcare system that doesn't  make any logical sense to me.

Offline Miss Philicia

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Re: Update on NC's ADAP Situation
« Reply #2 on: July 12, 2010, 01:46:05 PM »

I'm sure this is not enough to cover everybody, and that 125% FPL really sucks (currently, that's $13,538 for a 'family unit' of 1). 

What a joke.  If I lived down there I'd even be disqualified, and I'm on disability.
"Iíve slept with enough men to know that Iím not gay"

Offline skeebo1969

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Re: Update on NC's ADAP Situation
« Reply #3 on: July 12, 2010, 02:07:42 PM »
I'm sure this is not enough to cover everybody, and that 125% FPL really sucks (currently, that's $13,538 for a 'family unit' of 1). 

So basically what they're telling you is- we'll pay for your meds only if/when you cannot conceiveably take care of yourself.  How nice..
I despise the song Love is in the Air, you should too.

Offline Inchlingblue

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Re: Update on NC's ADAP Situation
« Reply #4 on: July 12, 2010, 02:11:34 PM »
These very low income thresholds for eligibility only disincentivize people from wanting to have a normal life.  In Europe or other places with national health care, people with chronic conditions can continue their lives normally and peacefully, working whatever jobs they already had regardless of income, knowing they won't be miserable worrying about getting sick and dying and accessing meds and treatment. Here, it must make many people want to give up trying to contribute to society and just become dirt poor and dependent on the State, since at least that means you have a shot at health care.

It's great that those at 125% of the poverty level will get help but that does not mean that someone at, say 300% (or even 400% and 500%), can afford meds any better.

Tomorrow the White House unveils their National HIV/AIDS Strategy. I want to have the "audacity of hope" that it will mean access to treatment for everyone who needs it but  . . . I can't muster such audacity or such hope.
« Last Edit: July 12, 2010, 02:30:33 PM by Inchlingblue »

Offline Billy B

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Re: Update on NC's ADAP Situation
« Reply #5 on: July 12, 2010, 02:15:37 PM »
Nice that the powers that be are not completely ignoring the situation but it is obviously inadequate.  I want to learn more about the qualifications for NC Medicaid. I see people who obviously should be on Medicaid who aren't and then other people who have Medicaid who seem to have financial resources. For example, I don't understand how adults can have Medicaid and private health insurance, when that health insurance is not a Medicare replacement policy. In the US we have this patchwork healthcare system that doesn't  make any logical sense to me.


GymRat- http://www.dhhs.state.nc.us/dma/medicaid/index.htm
As a NC resident I am glad that I am still working and insured and have not had to deal with this as of yet.
Billy
VL 4420 CD4 340 CD4% 24   3/15/10 Started I&T
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VL  UD   CD4 430 CD4% 28.8 05/11/12
VL  UD   CD4 370 CD4% 28.1 09/07/12
VL  UD   CD4 390 CD4% 32.3 03/14/13

Offline Hellraiser

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  • Posts: 4,136
  • Semi-misanthropic
Re: Update on NC's ADAP Situation
« Reply #6 on: July 12, 2010, 07:40:23 PM »
People keep asking me why I don't utilize my AIDS diagnosis to get everything I can get my hands on.  I have absolutely no interest in being provided for as long as I am able to work and do for myself.  One of the jobs I'll be interviewing for soon however is putting me in danger of crossing over the ADAP maximum limit and I won't be eligible for healthcare unless I go into the high risk pool.  I have been contemplating taking a job with a lower salary just to avoid this because I know I cannot afford my meds by myself.

Offline Inchlingblue

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Re: Update on NC's ADAP Situation
« Reply #7 on: July 12, 2010, 07:52:47 PM »
People keep asking me why I don't utilize my AIDS diagnosis to get everything I can get my hands on.  I have absolutely no interest in being provided for as long as I am able to work and do for myself.  One of the jobs I'll be interviewing for soon however is putting me in danger of crossing over the ADAP maximum limit and I won't be eligible for healthcare unless I go into the high risk pool.  I have been contemplating taking a job with a lower salary just to avoid this because I know I cannot afford my meds by myself.

One thing to keep in mind is that ADAP is not comprehensive health care. As much as it has helped many people with meds and labs if something happens that requires different meds or tests or hospitalizations, ADAP doesn't cover it.

The new job does not offer health care benefits? The high risk pool might not be that expensive for you, I think it's based on a person's age.

I can't believe they are making people wait 6 months after officially being denied health care before allowing them to buy into a high risk policy. How on Earth was that agreed to in the negotiations and why was it even brought up? I don't understand the logic. Let's see, "Gee, this person has cancer, let's not give them health care for 6 months after they've been denied coverage, maybe they'll just die in the meantime and we won't have to deal with them at all!"

A website was set up that supposedly supplies all the info. regarding the new plans:

http://www.healthcare.gov/


Offline GSOgymrat

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  • HIV+ since 1993. INTJ
Re: Update on NC's ADAP Situation
« Reply #8 on: July 12, 2010, 08:15:58 PM »
The ADAP situation is just one example of how messed up our healthcare system is. Personally I think it all boils down to values and what we care about as a society. Providing for the health of all our citizens should be a top priority but our current system illustrates that as a society we care more about capitalism and making profit. The fact that we are one of the wealthiest societies on the planet makes the fact that we would rather let people die then give them money for medication even more outrageous. Of course nothing that I am saying is new... sometimes I just have to vent.

Offline Inchlingblue

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Re: Update on NC's ADAP Situation
« Reply #9 on: July 13, 2010, 11:49:54 AM »
There's an article out today about New Jersey also lowering the ADAP income threshold and it ends with these words, which is related to what I was saying above:

Hyacinth Foundation director Kathy Ahearn-O'Brien said the change may force patients to quit their jobs to stay in treatment.

LINK;

http://www.nj.com/news/index.ssf/2010/07/nj_budget_cuts_950_hiv-positiv.html

What these states don't realize is that this is penny wise and pound foolish because many of these people are bound to end up getting sick and going to Emergency rooms, which will be an added drain on the economy.

Offline Miss Philicia

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Re: Update on NC's ADAP Situation
« Reply #10 on: July 13, 2010, 11:56:43 AM »
I have a good friend who is in my local LTS support group just lose his ADAP for being a mere $500 over the newly lowered eligibility level in New Jersey.  Fortunately since he's also got Medicare Part D he's not entirely up a river without a paddle, and he has investment income that he can use for the donut hole.
"Iíve slept with enough men to know that Iím not gay"

Offline Inchlingblue

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Re: Update on NC's ADAP Situation
« Reply #11 on: July 13, 2010, 12:03:36 PM »
I have a good friend who is in my local LTS support group just lose his ADAP for being a mere $500 over the newly lowered eligibility level in New Jersey.  Fortunately since he's also got Medicare Part D he's not entirely up a river without a paddle, and he has investment income that he can use for the donut hole.

That donut hole (the Republican's gift to Big Pharma) is scary. Have you seen this:

http://blogs.poz.com/dave/archives/2010/04/the_half-baked_donut.html

Why wait until 2020 to close it@@!! That's ridiculous. And with the kinds of numbers that David Capogna is quoting in his blog, how can a measly $250. rebate make any kind of dent?

Offline Jeffreyj

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Re: Update on NC's ADAP Situation
« Reply #12 on: July 14, 2010, 04:13:16 PM »
Pharmaceutical Assistance Programs???

What a joke. They won't help anyone. Everyone in the government(state and Federal) is very content on kicking the can down the road.

Do they understand that people will die?

Good for you David for contacting the Governor. We all have to start raising hell.
Positive since 1985

 


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