What would Anderson Cooper say about the promised ADAP funding?

“Keeping them honest” – where is the money?

The ongoing saga over the number of Americans living with HIV/AIDS being denied access to care under the AIDS Drug Assistance Program (ADAP) belongs on CNN's Anderson Cooper 360. The crisis has been escalating for over two years, full of its share of empty promises, demands for fact-checking, and people -- especially patients -- wondering what to believe. "Keeping them honest" couldn't sum it up any better.


Almost two months ago on World AIDS Day, December 1st 2011, President Obama thankfully promised an additional $35 million dollars that would go to state ADAPs. This money should have already been rolled out. However no state has yet to see any of these additional funds, and the frustration level in the HIV/AIDS community is building.

Also building are the ADAP waitlists in America; which on January 19th, 2012 totaled 4,611 individuals across 12 states waiting to receive the anti-retroviral medication they need to stay alive, remain healthy, and productive. While this number is down from a high of nearly 10,000 last year, once again, the number has steadily been on the uptick.

So what is the hold up? Where is this money? Where is it coming from, and when will it be allocated to the states?

The $35 million dollars is reallocated HHS (Health and Human Services) funds, but before the funds can be reallocated the OMB (Office of Management and Budget) needs to approve. Apparently, saving lives is not at the top of the OMB list. As PLWHA continue to wait for these funds more people will become infected, more people will be put onto wait-lists, states will try to change criteria making it difficult for people to get medicine, and sadly people will likely die.

Once approved by the OMB then states will begin the competitive process of requesting this additional money. The most competitiveness will be among states with waiting list and already implemented cost containment measures. This all takes time. A current guestimate on when this money may start to roll out is not until July 2012!! That would be 7 months from the date of the announcement made on December 1st, 2012!

Did you know on the first day of American intervention in Lybia it cost US tax payers $100 million dollars, and over the three month period from April – July a total of nearly $1 billion was spent on the war with Lybia? Why will it take 7 months to distribute $35 million in reallocated HHS funds to states with people who continue to wait for the medicine they need?

Since Obama took office a robust national dialogue on HIV/AIDS has taken place, the National HIV/AIDS strategy was developed, his administration has increased overall funding to record levels, he re-authorized the Ryan White care act, and eliminated the travel ban on HIV positive individuals entering the United States. He has done a lot of good when it comes to HIV/AIDS, but more must be done here at home. With the 2012 International AIDS Conference coming to Washington, DC, isn't it embarrassing for the United States of America to deny access to care to thousands of patients who desperately need it?

“We are at the beginning of the end of this epidemic” the President said on World AIDS Day 2011, and said on this day that his vision was that “…..every American can get access to life extending care” but that vision, neither is hope in insight for the thousands of Americans that continue to be on ADAP wait-lists.

Ohio ADAP Crisis Shapes Up as Firewall for ADAP Stakeholders Nationwide

As goes Ohio, so could the Nation. The Ohio Health Department is putting up a strong fight to lower the federal poverty limit from its height of 500% in July 2010, lowered to 300% at that time, to now have the ability to implement a potential income eligibility change to as low as 100 % FPL at any time with no notice to anyone with a stroke of pen. If that rule had gone into effect, it would mean in order to qualify for the AIDS Drug Assistance Program a single individual cannot make more than $10,890 a year in order to be eligible. Further, ODH could implement medical criteria one must also meet. Those given the highest priority will be PLWHA who’s CD4 counts are lower than 201. The medical criterion makes no mention of an important aspect of HIV care which is the Viral Load.

Back on December 14th, three Ohio HIV-Positive advocates with the assistance of The AIDS HealthCare Foundation won an injunction to these proposed rule changes in the Franklin County, Ohio Court of Common Pleas, resetting the FPL to 300%. ODH had proposed one set of rules, had a hearing, and then changed the rules to the above without telling anyone. The judge had ordered ODH to go back to the drawing board…and they did. The end result is the terrible rules listed above.

If the Ohio Health Department lowers the income limit to 100% FPL, nearly 2,600 of Ohio’s PLWHA will be forced off of ADAP (half of the program) , and countless others who will become newly infected will have no access to the medicine they need to remain healthy and alive.

Ohio is trying to implement these rules on the backs of the poor and vulnerable, especially those living with a potentially life threatening disease such as HIV/AIDS.

With today’s medicine PLWHA can lead long productive lives; they are at less risk of developing an opportunistic Infection, and in 2011 a ground breaking study stated those on Anti-Retro viral Therapy (ARV) are 96 percent less likely to pass the virus to their partner.

The Ohio Department of Health is soliciting comments from the public:

The Public notice process is as follows:

1) Public Comment Period- Once the rules have been reintroduced, the Department will solicit public written comments regarding the new proposed rules. This period runs until January 23, 2012

2) ODH Public Hearing- Once the Public Comment period has been completed, there will be a public hearing held in which all interested parties will be able to submit written or provide in-person testimony in support or in opposition of the new proposed rules. This hearing is mandated by the legislature to be within 31-45 days after a rule change is proposed.

3) JCARR hearing- Once an agency has completed the public comment period and has held the public hearing; the rules then go to a legislative committee to ensure that the agency has complied with the law in proposing the new rules. After this hearing, the agency final files to enact the new rules to bring them into effect.

How can ADAP stakeholders help:

Anyone from the United States can send an e mail to HCS@odh.ohio.gov emphasizing concerns over these proposed changes. In the subject line use: Rule 3701-44-03

Click to see ODH proposed Medical Rule Criteria proposed

Click to see ODH proposed changes to financial eligibility