Texas Health Officials May Alter ADAP Program Rules Despite More Funds From Legislature

Texas health officials on Thursday announced that they expect to get more aid from the Legislature to ensure that no one is cut off from the Texas HIV Medication Program, the state's AIDS Drug Assistance Program, the Austin American-Statesman reports. While the increased funds will prevent the program from having to impose enrollment limits immediately, the state Department of Health has devised a plan to change the rules of the program should the funds run out. The federal-state ADAP program provides free medication to low-income HIV-positive individuals. Many of the state ADAP programs are experiencing financial trouble due to high demand for the drugs, "soaring" prescription costs and state budget shortfalls (Roser, Austin American-Statesman, 5/8). The state health department in January proposed revised eligibility requirements under which people earning more than 140% of the federal poverty level, or $12,400 annually, would no longer be eligible for the program. Current requirements allow beneficiaries who earn up to 200% of the poverty level, or $17,720 annually, to participate in the program. If they had been approved, the new requirements would have effectively cut 2,500 people from the program's rolls by August 2005 and kept up to 50 new applicants from qualifying each month (Kaiser Daily HIV/AIDS Report, 3/3). The board delayed adopting the rules in February, saying that it was seeking better options.

Budget Concerns Cause for New Rules
The state Senate recommended a $20 million increase in funding for the program over the two-year budget cycle that begins Sept. 1, 2003, and the House recommended an increase of $28 million, according to Dr. Sharilyn Stanley, associate commissioner for disease control and prevention for the health department. In addition, HHS has contributed an additional $4.8 million in federal funds. However, the aid is not enough to cover the program's budget deficit of $8 million in the current fiscal year and a projected $36 million shortfall for the upcoming biennium. The program, which has a budget of about $114 million for the current biennium, needs $44 million to remain solvent through the 2005 biennium. Therefore, health officials are proposing rule changes to compensate for the expected shortfalls. The plan would require beneficiaries to pay an income-based fee, require new enrollees to demonstrate medical eligibility, temporarily suspend enrollment of new clients and stiffen income guidelines for new clients. The health department will hold more than 20 public hearings throughout the state to gather comments about the proposed changes (Austin American-Statesman, 5/8).