Alabama ADAP To Remove 200 People From Program Unless State Legislature Passes Emergency Funding

Alabama's AIDS Drug Assistance Program on Friday sent letters to the doctors of 200 HIV-positive patients who receive antiretroviral drugs through the program, saying that the patients will be dropped from ADAP unless the state Legislature approves $1 million in emergency funding by next month, the Birmingham News reports (Chandler, Birmingham News, 3/12). ADAPs are federal- and state-funded programs that provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals. The number of people on waiting lists nationwide for enrollment in ADAPs as of Jan. 24 was 592 in nine states, according to the latest "ADAP Watch" released last month by the National Alliance of State and Territorial AIDS Directors. President Bush in June 2004 ordered the immediate, one-time release of $20 million to purchase AIDS-related drugs for states with ADAP waiting lists, but only the 10 states that had waiting lists at the time of the order -- Alabama, Alaska, Colorado, Idaho, Iowa, Kentucky, Montana, North Carolina, South Dakota and West Virginia -- were eligible to apply for the funding (Kaiser Daily HIV/AIDS Report, 2/10). Alabama froze enrollment in its ADAP in 2004 and currently has 525 people on its waiting list, according to the News. In April, the "cash-strapped" program plans to remove the most recent 200 patients to join the program if the additional state funding is not approved, according to the News. "Our program is truly put together with Band-Aids and shoestring," State Health Officer Don Williamson said. State Sen. Roger Bedford (D), chair of the state Senate General Fund Committee, said that final approval of the $1 million in emergency funding likely will come next week, according to the News.

Other Funding Problems
The letters sent to the 200 patients are "only a symptom" of the problems with the state's ADAP, which is on the "brink of disaster," according to state health officials, the News reports. Kathie Hiers, CEO of AIDS Alabama, said that the ADAP is being "slammed" with new cases as the HIV/AIDS epidemic shifts to minorities and heterosexual women, according to the News. "I have friends in New York that are calling Alabama 'Ground Zero,'" Hiers said, adding, "It's the worst program in the country." Williamson said that about 30 people apply for the program each month, while only three people leave the program monthly, usually because of death, according to the News. Alabama might have to contribute an additional $3.5 million in matching funds next fiscal year to be eligible for $13 million in federal funding, according to the News. In addition, 390 HIV-positive people in Alabama receive drugs under the program using money from Bush's one-time $20 million release, and that funding has not been renewed for next year, according to Hiers. She said that the state will be forced to use $250,000 it has been using to pay case managers and transportation costs for AIDS service organizations to buy antiretrovirals, but the state's waiting list still could reach 1,000 people by 2006, according to the News. "I've described it as possibly the worst financial crisis I've seen in an ADAP program in my 10 years in the HIV field," Hiers said (Birmingham News, 3/12).