advocacy
ADVOCACY EVENTS
Campaign 2 End AIDS (C2EA) - National Walk across the country
Access 2 Protection - Access to Risk Reduction for Injection Drug Users
Lobby for Idaho AIDS Assistance Program (ADAP) with Governor Dirk Kempthorne
Vigil for those who have died from Drug Overdose (http://www.ktrv.com/global/story.asp?s=5800644&ClientType=Printable)
Prevention Justice Partnership - Community HIV AIDS Mobilization Project - New York & Providence
Dedication by Governor Dirk Kempthorne to Idaho HIV and AIDS Awareness Month
Additional Advocacy Projects
HIV
Medicare and Medicaid Working Group
Medicare Part D: ADAP
Expenditures Must Count Towards TrOOP
What
is the Issue?
When Congress established the Medicare Part D program, drug spending by
other government programs was prohibited from counting toward the calculation
of so-called true out-of-pocket costs (TrOOP), with one exception, state
pharmaceutical assistance programs. The Centers
for Medicare and Medicaid Services (CMS) has interpreted the law such that AIDS
Drug Assistance Programs (ADAPs) are not to be considered state pharmaceutical
assistance programs even though they are supported by significant state
contributions and must ensure that they are the payer of last resort.
How
does it affect people living with HIV/AIDS? TrOOP spending is a critical issue because it
determines when “catastrophic coverage” begins.
Catastrophic coverage begins when individuals with exceptionally high
drug costs move through the coverage gap by spending $4,050 in out-of-pocket
costs and their cost sharing falls to 5% of drug costs. TrOOP also is significant because these
expenses are used to determine when individuals exit the coverage gap known as
the donut hole. Because ADAP spending does
not count toward TrOOP, individuals can not move out of the coverage gap and
are therefore unable to access their Medicare drug formularies for
approximately between 9 to 10 months out of the plan year. These individuals
must rely only on ADAP, which in almost all cases has a much more limited
formulary than the typical Medicare plan.
Reasons
to Support Policy Change:
- Cost to Medicare
is Minimal: The
CHAMP Act passed by the House last session included a provision to allow ADAP
and Indian Health Service spending to count towards TrOOP. Those two programs combined were only expected
to cost $100 million over five years.
- States Make
Significant Contributions to ADAPs:
On average, state spending
accounts for 22% of the total ADAP budget. Fifteen states contribute more
than 25% of their state’s overall ADAP budget (Alabama, California,
Colorado, Georgia, Idaho, Illinois, Iowa, Missouri, Pennsylvania,
Tennessee, Texas) and five states contribute 40% or more of the ADAP
budget (Idaho, Nebraska, North Carolina, Rhode Island, Wyoming).
- Provide Cost
Savings to Lifesaving Discretionarily Funded Program: Total ADAP
spending reached almost $1.4 billion in FY2006, with states
contributing $305 million to the total.
ADAPs provide access to critical medications for approximately
140,000 individuals in communities across the
- Catastrophic Coverage
Frees Up ADAP to Cover Other Unmet Needs:
When ADAP does not count toward
TrOOP, it requires ongoing ADAP spending that cannot be used to help other
needy people with HIV/AIDS.
However, when ADAP does count toward TrOOP, catastrophic coverage
frees up ADAP dollars to help other needy individuals. The National Alliance of State and
Territorial AIDS Directors has estimated that if ADAP expenditures counted
towards TrOOP, it would save ADAP programs $25 to $44 million.
- The Majority of
ADAP Clients Live in Poverty: 82%
of ADAP clients live at or below 200% of the poverty level ($1,701 a month
in 2007) and 55% are at or below 100% FPL.
For those who just miss qualifying for the Medicare low income
subsidy, the cost of drugs can easily total $3,000 per month during the donut
hole period. In addition to their HIV regimen, people with HIV/AIDS also
need to pay for a host of other medications to treat co-occurring
conditions and side effects from their HIV treatment.
- On Average, 17%
of ADAP Clients are Medicare Beneficiaries: 69% of these
ADAP clients who are Medicare beneficiaries are also eligible for the full
or partial LIS. Approximately 30%
of these clients are standard beneficiaries who currently experience the
coverage gap.
The HIV Medicaid and Medicare Working Group (HMMWG) HMMWG is a coalition of nearly 100 national and community-based AIDS service organizations that represent HIV medical providers, advocates and people living with HIV/AIDS and provide critical HIV-related health care and support services. For more information, contact the HMMWG co-chairs Laura Hanen with the National Alliance of State and Territorial AIDS Directors at 202.434.8091 or Robert Greenwald with the Treatment Access Expansion Project at 617.390.2584.
To get involved locally email duane@alphaidaho.org, right now only good for month of April
Allies Linked for the Prevention of HIV and AIDS - Boise -Duane Quintana 208-424-7799
SUPPORT DRUG SENTENCING REFORM
FOR HIV PREVENTION JUSTICE!
The
link between incarceration and the HIV epidemic is deeply rooted and
complex. Unfair sentencing guidelines that punish crack cocaine
offenses 100 times more severely than powder cocaine have devastated
poor African American communities across the country. By locking up
large numbers of African American young men in long prison terms
instead of providing drug treatment for low level drug offenders, this
policy continues to create the conditions that drive the HIV epidemic
deeper into African American communities. If the United States is going
to seriously address systemic causes of the domestic HIV epidemic, drug
sentencing reform is a critical starting point.
Please join CHAMP in supporting Break The Chain’s
effort in urging Congress and the Administration to begin to address
this injustice. Sign on to the letter (full text at the end of this
email) by providing the following info and send it to champ@champnetwork.org:
a.l.p.h.a. has signed on to this important effort on October 3, 2007. dlq