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NY Court Waives Ryan White Care Act 75% Medical Spending Requirement
  Partial win for LI in AIDS suit
Nassau and Suffolk counties declared a partial victory Wednesday in a lawsuit filed against the federal government over the potential loss of millions of dollars in AIDS funding.
The lawsuit against the Department of Health and Human Services, announced Feb. 27 by Nassau County Executive Thomas Suozzi, sought among other things, a waiver to a provision of the Ryan White HIV/AIDS Treatment Modernization Act of 2006 that required that 75 percent of funding be used on core medical needs, with 25 percent going toward support services.
Wednesday the federal government granted the waiver.
With most residents having adequate medical insurance coverage, Long Island uses 50 percent of AIDS funds on medical needs with the other 50 percent going toward support services such as transportation to medical appointments and housing assistance.
Because of the area's high cost of living and limited public transportation, more money is needed for such services, county officials said.
The suit also contends that Long Island should be an "eligible metropolitan area" under the act. Last year, under a previous Ryan White law, Long Island qualified for $6.1 million in this category.
Because the law changed, Long Island has been reclassified and received only $3 million so far.
Added funding will be announced later this year but AIDS leaders predict an overall loss of $1.5 million to $1.7 million for both counties.
The lawsuit is in the U.S. Court of Appeals for the Second Circuit.
ADAP Waiting Lists
Source: NASTAD
As of January 17, 2007, a total of 558 individuals were on AIDS Drug Assistance Program (ADAP) waiting lists in four states.
In addition, six ADAPs have implemented other costcontainment measures in the ten months since the 2006 ADAP fiscal year began. Two ADAPs anticipate the need to implement new or additional cost-containment measures during the current ADAP fiscal year which ends March 31, 2007.
In the absence of sufficient federal funding that would enable ADAPs to meet the growing demand for Highly Active Antiretroviral Therapy (HAART) and other HIV-related medications, ADAPs have been forced to limit access to medications by instituting waiting lists and other costcontainment measures. Of the four states with ADAP waiting lists, two have had them for nearly two years. A third state has been forced to reduce its ADAP formulary in addition to maintaining an extensive and growing waiting list. The fourth state has recently instituted its waiting list and anticipates the need for other cost-containment strategies prior to the end of the ADAP fiscal year on March 31, 2007.
The House recently passed the "Revised Continuing Appropriations Resolution, 2007" (HJ Res 20). No additional funding was included for ADAP in the funding resolution, which, on top of an inadequate $2 million increase in FY2006, leaves the program lagging far behind its historical growth. The Title II base (Part B of the CARE Act), however, received an increase of $75 million. States are allowed to utilize Title II base funding for ADAP expenditures. The inclusion of this increase was necessary to ensure states are not unduly harmed under the "Ryan White HIV/AIDS Treatment Modernization Act," signed into law by President Bush on December 19, 2006. The Senate is to vote on the funding measure in the very near future.
ADAP traditionally grows at a rate of $100 million annually and with no additional funding in the FY2007 funding resolution, ADAPs will likely be unable to expand programs to include individuals who know their HIV status but are not receiving HAART. The estimated need for ADAP exceeds FY2006 funding levels by $197 million. Without substantial financial support, waiting lists and other cost-containment measures will continue to be a permanent feature of this critical program.
ADAPs provide life-saving HIV treatments to low income, uninsured, and underinsured individuals living with HIV/AIDS in all 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, and Guam. Since the advent of highly active antiretroviral therapy (HAART) in 1996, AIDS deaths have declined and the number of people living with HIV/AIDS has markedly increased. ADAPs have played a critical role in making HAART more widely available.
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