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Illinois ADAP Threatens Restrictions
  This year Illinois faces a $12 billion deficit. In an effort to balance the budget, lawmakers are looking for ways to trim spending wherever they can. This means state-funded programs, like ADAP, face sharp budget cuts.
According to John Peller, AFC's director of government relations, "Without additional state funding, hundreds of people with HIV will be cut from the program or put on a waiting list."
Compounding ADAP's funding crisis is the number of people enrolling in the program, which is expected to increase 15 percent in 2010. At a time when Illinois is already projected to spend $18 million on ADAP this year, AFC reports that the program needs an additional $10 million to keep pace with new enrollment, and meet the needs of current clients.
More than 4,000 people will seek ADAP services each month. Yet, it is the human toll behind these numbers that is staggering. Most ADAP recipients have no other options for accessing HIV medications. Without access to these medications on a daily basis—if people are, in fact, put on waiting list, or cut from the program due to budget cuts—the results could be fatal.
What a clear example of what a fiasco this budget is," said State Senator Heather Steans (D-Chicago).
Steans was commenting on a state advisory panel vote on May 21 to urge the state to immediately close the Illinois AIDS Drug Assistance Program (ADAP) to new applicants and begin a waiting list that has generated furious push-back from advocates and state lawmakers.
"Because the program is deeply underfunded, Illinois must take immediate steps to preserve services for those who rely on ADAP for their life-saving care," said David Ernesto Munar, vice president of AIDS Foundation of Chicago (AFC), and a member of the ADAP Medical Issues Advisory Board, which made the recommendation.
The Medical Issues Advisory Board, comprised of doctors, pharmacists, legal experts, advocates, and people with HIV, advises the Illinois Department of Public Health on ADAP policy. Jointly funded by the state and federal governments, ADAP provides HIV medications to low-income, HIV-positive Illinoisans who lack the money to purchase costly HIV medicine.
The recommendation is now under review by state officials--and under fire from advocates and legislators.
"We call on Illinois Governor Pat Quinn, the Illinois General Assembly and the federal government to provide immediate assistance to maintain this and other core public health and HIV programs," said AFC President/CEO Mark Ishaug.
In addition to Steans, other state lawmakers are already voicing strong opposition to the panel's recommendation.
"I am undone by this. More than 14 years ago, I began my career in the legislature fighting to ensure that life-saving drugs were available to people with HIV/AIDS and I will continue to fight this year," said State Rep. Sara Feigenholtz (D-Chicago). "I will work with Governor Quinn to find the money necessary for HIV medicine to keep people alive."
State Rep. Greg Harris (D-Chicago) says even in a budget crisis HIV/AIDS medication should be a priority-funded program:
The state's financial situation is in veritable collapse. There is no way to resolve the budget crisis without a combination of major budget cuts, strategic borrowing and revenue increases. That being said, we must give priority to programs like ADAP where being put on a waiting list, or providing inadequate funding is the difference between life and death for thousands of people across Illinois.
In particularly strong language, House Deputy Majority Leader Lou Lang (D-Skokie) called on Quinn to flatly ignore the state medical panel's budget recommendation:
Putting people infected with the HIV/AIDS virus on a waiting list for medication is like putting them on death's row. I urge Governor Quinn to reject the Medical Issues Advisory Board's recommendation to create a waiting list for HIV/AIDS medication."
The Illinois General Assembly will convene this week in Springfield to finalize the fiscal year 2011 state budget.
Advocates estimate that an additional $9.68 million in state funding in fiscal year 2011 is needed to avert a waiting list. In April 2010, 4,391 Illinoisans with HIV obtained HIV medications through ADAP, a new record. Each month, more than 100 people join the program.
Without ADAP or adequate insurance, HIV medications are beyond the reach for most people. An HIV medication regimen can cost as much as $20,000 per year.
"We clearly need to make judicious cuts that do not impact our neediest citizens and ultimately cost the state more," said Steans.
"In this case not only is the program more humane but it prevents people from having far more serious health needs that the State will also have to cover."
"People of color will be most impacted by a closed program and waiting list," said Rev. Doris Green, AFC director of correctional health and community affairs. "Two out of three people using Illinois ADAP are African American or Latino."
Quinn is, however, non-committal on ADAP funding.
"Governor Quinn continues working with lawmakers to pass a responsible budget that funds vital programs for Illinois residents," according to statement released by the Governor's office.
ADAPs across the nation are facing financial crises. Illinois would become the 12th state to institute a waiting list if the advisory panel's recommendation moves forward. More than 1,000 individuals are currently on ADAP waiting lists across the U.S.
"It's a national embarrassment that people with HIV can't get access to the medications that will allow them to work, thrive and contribute to society," said Munar, who is living with HIV.
Let's hope Governor Quinn can scrape up the commitment and the $9.7 million out of a $25 billion budget to provide HIV/AID drugs to help keep people, your neighbors, alive. We think he can.
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