One idea for AIDS Drug Assistance Program: Make eligibility more restrictive

Carl Schmid — deputy executive director of The AIDS Institute, a Tampa- and Washington, D.C.-based HIV/AIDS research and policy agency — tells The Florida Independent that the Florida Department of Health’s Bureau of HIV/AIDS last week proposed making it harder to access the state’s AIDS Drug Assistance Program by requiring that patients’ income be 200 percent or less of the federal poverty level. Currently, patients must earn 400 percent or less of the federal poverty level.

The Department of Health has not yet responded to calls or emails about the proposal.

The Drug Assistance Program is a taxpayer-funded last resort for people living with HIV who do not have health coverage or cannot afford their medications. The waiting list is one of several cost-containment measures created by the state to deal with the ongoing Drug Assistance Program crisis that is a result of increased demand for the program that has been fueled by Florida’s struggling economy.

As of March 31, more than 3,900 Florida HIV/AIDS patients are on the AIDS Drug Assistance Program waiting list.

Health department statistics (pdf.) show that Miami-Dade, Broward, Hillsborough, Orange, Palm Beach, and Duval counties account for about 2,800 of the total number of people on the state’s waiting list.

Explaining the Bureau of HIV/AIDS’ new proposal to make eligibility more restrictive, Ted Howard, communications coordinator for The AIDS Institute, says that the current federal poverty level for an individual is around $13,000. If the bureau’s proposal were adopted, a patient would have to earn $26,000 or less to qualify.

“If you make $30,000 a year, you wouldn’t qualify to ADAP,” says Schmid. “The drugs cost between $10,000 and $20,000 a year. You’d spend half your income on drugs.”

That would cut off more people from the Drug Assistance Program and put them on the state’s waiting list. Schmid says that right now the pharmaceutical companies are picking up the cost for those medications, but how long the industry will maintain those programs is unknown.

The Department of Health has scheduled three public meetings in Tallahassee, Tampa, and Miami, each of which will include a discussion of the proposed “changes to the Federal Poverty Level” as well as other issues about Drug Assistance Program eligibility. (Read full agenda below.)

Schmid says that Florida only contributes 9 percent of the Drug Assistance Program budget, while in other states the contribution is much higher. The state decreased its contribution by $1 million about two years ago, a step that contributed to the funding crisis.

“I understand in Florida the Senate has put in an increase of $3 million for ADAP but it wasn’t in the governor’s budget or the House budget,” Schmid tells the Independent. “The goal now is that we get it in the final budget.”

Nationwide, more than 7,700 people on the Drug Assistance Program waiting list. According to Schmid, that number will only grow. He says HIV/AIDS patients and their families and friends will find themselves with the same worries next year.

“Whatever we get from the federal government, even if we got the $78 million, won’t address all the program growth going into next year,” he says. “We don’t see the situation getting better.”