POZ Community Forums
Meds, Mind, Body & Benefits => Insurance, Benefits Programs & HIV => Topic started by: leatherman on December 04, 2011, 05:27:54 pm
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ADAPs with Waiting Lists as of December 1, 2011
4,274 individuals in 12 states
| STATE | AMOUNT | CHANGE |
| Alabama | 85 | +10 |
| Florida | 806 | -2,407 |
| Georgia | 1,520 | -5 |
| Idaho | 5 | 0 |
| Louisiana** | 515 | +40 |
| Montana | 9 | 0 |
| Nebraska | 9 | 0 |
| North Carolina | 106 | +11 |
| Ohio | 0 | 0 |
| South Carolina | 92 | +27 |
| Utah | 23 | +10 |
| Virginia | 1,104 | +7 |
ADAP Dec. 2nd Watch List (http://www.nastad.org/Docs/034845_ADAP%20Watch%20update%20-%2012.2.11.pdf)
**Louisiana has a capped enrollment on their program. This number is a representation of their current unmet need.
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Well isn't this fascinating, considering Republicans control almost every arm of government in Virginia and have a right wing ideologue Attorney General (who just participated as a questioner in the recent GOP debate) suing the government about the constitutionality of the Affordable Care Act.
A program that pays for patients' lifesaving HIV medications could get more bang for its buck by instead paying those patients' premiums to enroll in a federally run health insurance program for people with pre-existing medical conditions.
The change to the Virginia AIDS Drug Assistance Program, called ADAP for short, will come in January, state health officials said during a public hearing this week.
"ADAP dollars are going to be used to pay for the premiums," said Hunter Robertson, HIV services planner at the Virginia Department of Health, at the event in Richmond on Tuesday.
"By doing that, we will be able to give them their medication and medical care. … We will be paying their premiums and out-of-pocket expenses," Robertson said. (http://www2.timesdispatch.com/news/state-news/2011/dec/03/tdmet02-vas-aids-drug-assistance-program-to-make-c-ar-1510516/)
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Wow, what happened in Florida? Did someone stumble over a bag of money that had been "misplaced" or what?
PS - that's pretty amazing what's going on in VA.
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"paying those patients' premiums to enroll in a federally run health insurance program for people with pre-existing medical conditions."
wonder if this also means those people who were on ADAP and now will be enrolled in this insurance program, will also have insurance coverage for everything else besides just medications (which is all ADAP supplies)? That would be very cool.
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Florida's dramatic change came from finally spending Federal funds, getting emergency funds, dropping the amount of prescriptions ADAP will cover for each patient, and raising eligiblity from 200 to 400% FPL
http://floridaindependent.com/59099/adap-wait-list-numbers-drop
The AIDS Institute hosted a Florida Bureau of HIV/AIDS Patient Care Webinar Friday to address several issues, including changes to ADAP.
Tom Liberti, chief of the state’s Bureau of HIV/AIDS, explained during the webinar that Ryan White federal funds that added up to almost $9 million dollars and $6.9 million in federal emergency relief funds allowed the Bureau to reduce the state’s ADAP waiting list.
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Joe May, also from the Bureau of HIV/AIDS, said during the webinar that opposition to a Bureau cost containment measure to reduce eligibility to the ADAP program, from 400 percent of the federal poverty level to 200 percent, has been duly noted.
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In another cost containment measure, Florida also reduced the number of medications available to people in the AIDS Drug Assistance Program. Responding to questions about the reduction, May and Wells said the prescription list supplied by ADAP will remain stable.
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raising eligiblity from 200 to 400% FPL
So in other words, there are probably just as many (if not more) who are going without meds or care as there ever were, they're just not showing up as such. Way to cook the books! Somebody needs to kick some ass in Florida. >:(
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You Bible belt queers scare to hell outta me, I'm glad I don't live in one of these horrid states ::)
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You Bible belt queers scare to hell outta me, I'm glad I don't live in one of these horrid states ::)
You and me both, Dennis. It truly is frightening what they're getting away with. I am grateful beyond words to have the NHS, warts and all.
No wonder we have the stats like what are outlined in Tim Horn's recent article published just before WAD...
CDC: Only 50% of People With HIV in U.S. Get Regular Care (http://aidsmeds.com/articles/hiv_care_treatment_1667_21528.shtml?)
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You Bible belt queers scare to hell outta me, I'm glad I don't live in one of these horrid states ::)
the BBC even did a story about stigma in the South (http://www.bbc.co.uk/news/magazine-15972527) for WAD. So a while ago when I talked about how religious stigma plays into a lot of the issues surrounding the HIV problem in the South, I wasn't just whistling Dixie ;)
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@ Ann Mark Lewis (aztecan) posted this on FB this weekend, and I read the whole report, very SHOCKING to say the least ???
@ Mikie @ least you are smart enough to get treated for your AIDS, and your out there trying to make a difference in your neck-of-woods, so don't feel bad about any of it (living in the Bible belt) that is ;)
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the BBC even did a story about stigma in the South (http://www.bbc.co.uk/news/magazine-15972527) for WAD.
From the BBC article:
''I think we're still going downhill. Until we open our eyes and really talk about it, it's not going to get better,'' says Ms Starr, a Pentecostal preacher who has taken to handing out condoms at her church.
Ms Starr is aptly named - she really is a star. A Pentecostal preacher handing out condoms has got to be a rarity. More power to her! She's lost eight members of her family to aids - and that's a story you'd expect to hear from a place like Zimbabwe, not the US. It's just a shame that it takes the death of family members to wake people up. At least Ms Starr not only woke up, but is actively trying to do something about it. Good for her.
Mike, do you by chance know her? I see she lives in Clover, one of the communities served by Catawba Care, the people you do volunteer work with.
@ Ann Mark Lewis (aztecan) posted this on FB this weekend, and I read the whole report, very SHOCKING to say the least ???
Yes, I saw his link and I meant to read it, but I got distracted by something shiny, as usual. I'm glad Mike also posted it here - I needed the reminder.
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Also from the BBC article....
In the American South, HIV/Aids remains a silent epidemic.
In no other part of the US are the death rates from the disease as high. Poverty, religion, culture and neglect have all played their role in keeping it this way.
And it's the South's African-American population which has suffered most.
Is it my imagination, or is racism the elephant that's being left off the list of causes?
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It's not just the South with that issue -- like the article said this is stemming from African American communities. Take a snapshot of where I live (44% black) or any other NE urban area (but not the rural, it's flipped), as well as mid-western cities like Detroit, Chicago, St. Louis it's the same. It's just concentrated in dense urban areas instead of spread out over an entire state. It's not like stigma in black communities doesn't exist up here.
I wouldn't be surprised if Philadelphia's number of infected African Americans equals the same as in South Carolina. And as I stated state statistics aren't always great reflections for infection clusters geographically. For example, lay a line 150 miles wide with Interstate 95 in the middle, from DC to Boston (450 miles long -- not all that different as from San Francisco to Los Angeles), and the aggregate numbers would be startling. I would not be surprised if the numbers were 70% non-white.
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Is it my imagination, or is racism the elephant that's being left off the list of causes?
it's hard to tell. There are just a lot of Africa-Americans in the South compared to other regions.
http://www.censusscope.org/us/map_nhblack.html
However, poor whites and poor blacks in the South are equally left without enough resources (ADAP for example)
Here within a range of several Southern states, I would add lack of education (and HIV education/prevention specifically) to the list of "Poverty, religion, culture and neglect", long before racism
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OK, fair comment on the racism issue. I wasn't sure, so I asked. Thanks to you both for the clarification.
Ahem...
Mike, do you by chance know her? (Ms Starr) I see she lives in Clover, one of the communities served by Catawba Care, the people you do volunteer work with.
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Mike, do you by chance know her? I see she lives in Clover, one of the communities served by Catawba Care, the people you do volunteer work with.
sorry, I didn't see that earlier. Blame it on brain fog or old eyes. LOL No, I don't know her personally; however since that article appeared I have chatted with a couple of clinic clients that do know her. It was only because I was working late just before our WAD event that I even had the opportunity to meet these clients. They come to the special night-time clinic hours we offer and enter through our back door to keep it hidden that they come to a clinic such as ours (which is just another one without HIV or AIDS in their name).
Clover, on the far side of the county, is another little burg that probably doesn't get near enough attention from any agency, state or federal. I was over there in the early part of summer with the Catawba Care display (and free condoms!) for their local SummerFest in "downtown" (and after yrs in Charlotte and Cleveland, I use that word loosely describing any part of Clover LOL); but we haven't been back since.
I should point out that we haven't been back because we are shirking our duties or something; but we haven't been back because no one wants us. We only got into the SummerFest through the efforts of our partners United Way and Piedmont Medical Center that hosted the "Healthy Hometown" section of the street festival. Although our prevention staff has been trained by the state of SC in sex-ed and the legalities of what can and can't be discussed as part of SC education curriculum, we have a hard time finding any school, church, or civic organization that would like to host us.
This is a problem we have throughout much of the three-county area that we serve. We do get better response in the Rock Hill, SC area of York county as that area, about 10 miles straight down the I-77 corridor, is truly more of a suburban area of Charlotte, NC and hence not quite as rural (aka "backwards" or "hick").
Elsewhere in rural York County, Lancaster County and Chester County, we have to repeatedly ask (sometimes for years!) before we grudgingly get invited to just distribute STD and HIV information - often with the restriction of NOT passing out or displaying any condoms at all. (heaven forbid we should offend anyone! sigh!) I have actually been requested at several events to stash "safer sex packets" away (a count of six condoms, with 2 lube packets, instructions for condom usage, and testing info wrapped tightly in small brown paper bags). I know of 2 events this Summer, where we had set up our health-fair booth, that we have been asked not to return to next year because the event coordinator believes that we shouldn't be talking about "that kind of stuff" publically.
After my years of living with the Yankees in the Cleveland Oh area, I find these religious and rural viewpoints about the appropriateness of condoms and STD/HIV education pretty crazy, especially in a state ranked #9 in highest infection rate. When you see though how the church reinforces the negative stereotypes against sex, gays, sex-ed and HIV, and how that gets reinforced by the negative comments from and lack of resources voted on by local legislators, it's no wonder HIV is a huge program that is not-to-be-talked-about in the South.
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While I definitely do not support how Florida has been dragging its feet on remedying the ADAP wait list crisis - one important clarification - Florida's income eligibility is set at at 400% of FPL - it has not been officially changed to 200% yet. There were also a host of medications included on Florida's list that really had no rational reason for being on it (the cost containment that will come from removing some of those medications, will not have an adverse impact on a person's care from what I have been able to ascertain from a friend of mine who is on the state ADAP advisory board).
While any change in income eligibility has an impact on person's who might have currently be eligible under the guidelines of 400% - Florida's proposed change in guidelines are actually in line with what many other states already have in place or have put in place.
Examples of states that have lowered financial eligibility:
Arkansas from 500% - to 200%
Illinois from 500% to 300%
North Dakota from 400% to 300%
Ohio from 500% to 300%
South Carolina from 550% to 300%
Utah from 400% to 250%
So, not all states that have implemented reductions in financial eligibility have been southern states.
The one big complaint that I have always had as a Floridian is that we are one of the very few states that has NO state income tax - as such, we are a state with a lot of wealthy people, but that $$$ does not flow at all into state services, thus we rank low in education, health care, and other human services. It really is a shame - but no politician wants to commit political suicide by recommending at least a 1% state income tax. Instead we rely on tourism for most of the state's revenues - with the Orlando and Miami area contributing the lion's share to the state budget via tourism and corporate taxes.
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No, I don't know her personally;
Well Mike, if you ever do meet her, let her know there's an ex-pat on the other side of the pond who has an awful lot of respect and admiration for her. She rocks.
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Leatherman, the FPL income requirement was never dropped from 400 to 200percent down here in florida. It was only being considered. But it never happened. Otherwise i would have lost my meds too. The reason for the huge drop in the number on the waiting list are from the other reasons u listed.....esp the extra money. Had nothing to do with the FPL.
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thanks for that update. ;) that's what phildin told us too.
On the day I originally posted that information about Florida ADAP, the final decision about income eligibility had not yet been decided (according to information from the FL ADAP site and local Florida news reporting). It's good to see that they didn't take that drastic of a measure.
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ADAPs with Waiting Lists as of December 15, 2011
4,333 individuals in 12 states
| STATE | AMOUNT | CHANGE |
| Alabama | 90 | +9 |
| Florida | 1,078 | +124 |
| Georgia | 1,175 | -4 |
| Idaho | 11 | 0 |
| Louisiana** | 575 | +33 |
| Montana | 10 | 2 |
| Nebraska | 12 | 2 |
| North Carolina | 113 | +1 |
| Ohio | 0 | 0 |
| South Carolina | 140 | +3 |
| Utah | 27 | +2 |
| Virginia | 1,102 | +6 |
ADAP Dec. 16th Watch List (http://nastad.org/Docs/095527_ADAP%20Watch%20update%20-%2012.16.11.pdf)
**Louisiana has a capped enrollment on their program. This number is a representation of their current unmet need.
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Looks like Florida is going back up in terms of numbers on the wait list. That dropping trend didnt last long. I tend to worry also the way Florida mismanages it's ADAP funds combined with them taking all those people off the wait list. I get the feeling near to when the fiscal year ends money is going to dry up like it did last year and people are just going to be put right back onto the wait list again. God only knows who they are going to take off with them adding over 3000 new people to the rolls.
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I think I remember reading somewhere, that like SC, the Florida legislature budgeted less than last year for ADAP. That means that not only did they not provide enough funds to fully cover all the people already getting meds (which means people will be dropped again when they go bankrupt like this past year) but that also means they didn't provide enough funds to cover all the new people who will needs meds and should be eligible for ADAP.
Because HIV can be a long-term treatable illness now, the numbers who need ADAP should constantly ris each yeare as new cases are diagnosed. The only mitigating factors would be how many people on ADAP have an increase in income to then move off the ADAP roll, and how many people are able to obtain meds through other sources, or how many people currently on the roll pass away and free up resources.