Public Comment by The AIDS Institute before the Presidential Advisory Council on HIV/AIDS


January 27, 2011
Washington, DC

Good afternoon. My name is Carl Schmid, Deputy Executive Director of The AIDS Institute.  We have come before you several times over the past year to ask you and the Obama Administration to address the crisis in the Ryan White AIDS Drug Assistance Program.  We appreciate the resolution you passed in support of $126 million in emergency funding, the $25 million in emergency funding identified by Secretary Sebelius, and the President’s $30 million midyear budget request.  Unfortunately, none of those steps were adequate and NASTAD now reports that there is a waiting list of 5,550 people in 10 states.

Last February, when you first met, there was an ADAP waiting list of just 362 people.  In April, it had grown to 938, and when you met in June it was at a historical record of 1,840 people.  Today it is three times larger.  Wait lists are just one measure of how a state ADAP is doing.  States are reducing their formularies and their eligibility, and in the process, actually disenrolling hundreds of patients from the program.

The situation is so severe in the Florida that they are planning to remove 6,400 people from their program for two months beginning February 1st  so they can make it through the end of the ADAP calendar year on March 31st.  In the meantime, the plan is for patients to receive their medications from a pharmaceutical sponsored charity.  Florida is not alone, Virginia is in the process of moving 760 people off of its program and Washington State is planning to disenroll 500 people. You can see that unprecedented actions are being taken all across the country.

We were pleased that in the last Congress, funding proposals by the House of Representatives called for an increase of $60 million for fiscal year 2011, while the Senate proposed an increase of $65 million.  Incorporated in both these proposals was a continuation of the $25 million in emergency funding, so the actual proposed increases would have been actually less.  Unfortunately, the last Congress did not pass a full year spending bill and we are operating on a continuing resolution at current funding levels until March 4th.

A new Congress has now been constituted and there are rallying cries from many members to significantly cut spending. The ADAP program cannot afford to be cut.  Could you just imagine how long the waiting list would be or how many patients would be disenrolled from the program if funding was cut?  A twenty percent cut to the program would be $172 million, and would translate into cutting over 19,100 people from the program.  Even with level funding, the situation would continue to be grave since ADAP utilization continues to skyrocket.

Therefore, we need the Congress to protect ADAP from any cuts and actually increase funding by at least the $65 million that was proposed by the Senate for FY11.  We also need the Obama Administration to forcefully insist on these increases as they work with the Congress.  We also need the President to propose adequate increases in FY12 and relay the urgency of this request to the Congress as they deliberate next year’s spending bill.  Today we are highlighting the ADAP crisis; at the same time we strongly support adequate funding for all parts of the Ryan White Program, HIV prevention at the CDC, AIDS research at the NIH, and HOPWA.

We know we are living in challenging times and record budget deficits and there is a call for spending freezes and cuts.  In the process, programs must be prioritized and protected from cuts.  We ask you to ensure that ADAP is one of those programs.

Carl Schmid

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