Florida joins the growing list of states forced to cut drugs for HIV/AIDS patients due to budget issues.
Thousands in jeopardy of losing coverage
It appears Florida’s struggling economy has found its latest victims: uninsured HIV/AIDS patients. According to the Florida Department of Health’s Bureau for HIV/AIDS, a budget crisis is forcing the state to drop 350 uninsured HIV/AIDS patients from a federal drug subsidy program, and an additional 2,000 more patients may suffer the same fate.
The need to drop patients from the AIDS Drug Assistance Program (ADAP) stems from Florida’s $16 million shortfall of its $100 million drug program budget. Another factor affecting the cuts is the economy, which has triggered an increase in the number of Florida patients being enrolled in the program due to loss of employment and health insurance. The Bureau estimates the current enrollment to be approximately 11,000 patients. The lack of funding has forced the agency to put patients on a waiting list.
“We have not had this type of demand in 14 years,” said Tom Liberti, chief of the Bureau of HIV/AIDS. “We knew we had to have a waiting list quickly because we were over budget.”
Liberti, who estimates there are more than 2,400 patients on the waiting list, says the Bureau began putting patients on the list June 1. Of these patients, more than 1,000 live in South Florida and approximately 300 live in Central Florida. In a state that has the third largest HIV/AIDS epidemic in the country, having to drop patients from ADAP is not something the Bureau wanted to do, says Liberti. New York and California rank No. 1 and No. 2.
Flat funding from the Ryan White program, the economy and the increased number of patients came together to create what Liberti calls the “perfect storm,” which started in early 2009. While the Bureau, which has been around for more than 20 years, is trying to stabilize the program, it’s not there yet, he says. If the financial situation does not improve, there is a strong possibility that more patients could be dropped from the program.
“When people are diagnosed … they often need to be on medication right away,” said Lola Thomas, executive director of the AIDS Alliance of Northwest Georgia, one of the states that has a waiting list. “It’s devastating to the HIV community. It becomes difficult to keep up with the program.” As far as Florida is concerned, there are no guarantees that more patients won’t be cut, but the Bureau is trying to make it through March 31 of next year before any additional cuts are made. Liberti estimates that the state saves about $10,000 per every patient dropped, but that is not the ideal scenario.
“Everyone is trying very hard so that we don’t have to do that. I’m trying to stay optimistic,” Liberti said. That optimism is linked to several grant programs totaling millions of dollars, some of which the state has never been eligible for until now. The downside is the fact that grant awards aren’t usually handed out until at least April 1. Liberti says his office is going for as much money as possible.
In the meantime, dropping patients from ADAP and reducing eligibility were the immediate steps that had to be taken to ensure the program could stay afloat. Some of the patients being dropped may be able to obtain drugs for free or at a minimal cost directly through programs offered by drug manufacturers. The state is assisting patients in this process.