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Drastic Cuts to Floridians with HIV/AIDS Being Considered

by Jason Parsley
Wednesday May 11, 2011

All over the nation states are considering reducing the eligibility threshold for many AIDS programs, and Florida is no exception.

The current income eligibility requirement in the state is 400 percent of the Federal Poverty Level. The state may reduce that to 200 percent. But opponents of any reduction say it would cut Floridians living with HIV/AIDS off from lifesaving HIV/AIDS medication, care and services.

Currently there are 9,600 patients using AIDS Drug Assistance Programs in Florida and 3,700 on waiting lists. Tom Liberti, Chief of the Bureau of HIV/AIDS at the Florida Department of Health, said if the state lowers the eligibility to 300 percent it would affect around 300 people, while at 200 percent it would affect about 1,600 people.

Liberti added that, even if his department ends up recommending a reduction, he would also recommend those patients currently receiving assistance be grandfathered in. The problem isn't that the state or federal government is slashing their budget. In fact, the funding has stayed relatively the same over the last few years.

But it turns out that is the problem. With the collapse of the economy and high unemployment rates additional people are seeking assistance.

"We have massive unemployment and 4 million people in Florida are without health insurance, but we haven't received any increases in federal or state appropriations," Liberti said, adding his department is looking at other options as well.

"We're working on a number of different fronts," he said. "All factors will be taken in to recommendation. That's why we're taking input from the people about the change itself."

More than 1,000 people attended he four public hearings Florida held recently about the possible changes.

"It's been very moving. People have been testifying about their personal life and situation," he said. "Almost 100 percent of the people have been opposed to lowering it to 200 percent.

Normally by this time he knows how much money he'll be receiving from the federal government, but because of budget delays in Congress those numbers haven't come in yet. He's still hoping for an increase. There's also an ADAP supplemental fund Florida hasn't been eligible for in the past because the state never had patients on waiting lists.

The waiting started last June when the state decided to close the program to new enrollees. Now with 3,700 patients on the list he's hopeful Florida will receive some additional funds.

"We were not eligible for it in the past because we didn't have a wait list," he said. "That could be a multi-million dollar award."

Capping the program was just one of the cost containment measures the state did last year. They also reduced the list of approved drugs from 100 to 50. Now they're looking at the eligibility requirements.

No recommendations will be made until late summer or early fall. After that the public will have another opportunity to discuss the changes. Liberti said other states have or are considering reducing eligibility requirements. In Illinois for instance they recently reduced their eligibility from 500 percent to 300.

AIDS Health Care Foundation is adamantly opposed to any eligibility reductions and is urging residents to contact their local representatives to voice their concerns. AHF argues the move would increase medical costs to the state in the long run as AIDS patients would naturally end up seeking more expensive emergency care at hospitals around the state.

"If this continues to move forward we will take our fight all the way to Tallahassee," said Jason King, Patient Advocate for AHF.

King understands times are tough and so his organization has come up with several suggestions of their own that do not include reducing the eligibility percentage. Those include more funds from the state, dispensing generic drugs in lieu of brand names, and making sure medication isn't being dispensed after the patient is no longer taking it.

"A huge problem though is drug pricing," King said. "We don't believe they've done enough work to bring down those costs."

Liberti agrees. Negotiating better drug prices is on his list as well.

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