32
AIDS Drug Assistance Program Improving Health. . . Promoting Wellness
AIDS Drug Assistance
Program
Improving Health. . . Promoting Wellness
OUR MISSION
To Provide Life-Saving Medications, Disease Management Training and
Information to Our Clients in a Cost-Effective Way.
FloridaADAP
FloridaADAP
54%
14%17%
12%
3%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
≤ 10 0 %
10 1 – 13 3 %
13 4 – 2 0 0 %
2 0 1 – 3 0 0 %
3 0 1 – 4 0 0 %
Federal Poverty Level RW 2009/2010
Clients Enrolled 18,022
Source: ADAP Database. Reported on September 23, 2010.
2009/2010
GENDER & RACE/ETHNICITY
(18,022 CLIENTS)
1%
71%
28%
MALE
FEMALE
TRANSGENDER
36%9%
26% 28%
1%
WHITE NON-HISPANICBLACK NON-HISPANICHAITIANHISPANICOTHERS*
RACE/ETHNICITY OTHERS* (193 CLIENTS)
45%31%
14% 9%
ASIANSPACIFIC ISLANDERSNATIVE AMERICANSMULTIPLE RACES
FloridaADAP
Fiscal Year 2009/10 (April 1st thru March 31st)
GENDER & RACE/ETHNICITY
Fiscal Year 2009/2010
(18,022 CLIENTS)
0% 0% 0% 0% 2% 1%
31%
12%
37%
14%
2% 1%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% O
F C
LIE
NT
S
≤2 2 - 12 13 - 24 25 - 44 45 - 64 ≥65
AGE
Male
Female
Source: ADAP database. Reported on March 29, 2010.* Total number of clients as of the last day of the fiscal year, March 31.
FloridaADAP
FloridaADAP
Trends Affecting ADAP
Drug Pickup (page 1 of 2)
Source: ADAP Database. Reported on September 23, 2010.* The total number of clients for each fiscal year represent clients open anytime during the given year. The percentages represent clients who picked up at least once within the month.
42%45%
42% 41%44%
49%
69%66% 64%
71%68%
70%72%
71% 71%73% 72%
74%76%
68%
75%73%
71%
77%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Ap
r-0
7
May
-07
Jun
-07
Jul-
07
Au
g-0
7
Sep
-07
Oct
-07
No
v-0
7
De
c-0
7
Jan
-08
Feb
-08
Mar
-08
Ap
r-0
8
May
-08
Jun
-08
Jul-
08
Au
g-0
8
Sep
-08
Oct
-08
No
v-0
8
De
c-0
8
Jan
-09
Feb
-09
Mar
-09
FISCAL YEAR 07/08
14,396 clientsFISCAL YEAR 08/09
15,569 clients
FloridaADAP
Trends Affecting ADAP
Drug Pickup (page 2 of 2)
Source: ADAP Database. Reported on September 23, 2010.* The total number of clients for each fiscal year represent clients open anytime during the given year. The percentages represent clients who picked up at least once within the month.
73% 71%70%
75%72%
74%76%
71%
79%75% 74%
79% 78%76%
84% 84% 85%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%A
pr-
09
May
-09
Jun
-09
Jul-
09
Au
g-0
9
Sep
-09
Oct
-09
No
v-0
9
De
c-0
9
Jan
-10
Feb
-10
Mar
-10
Ap
r-1
0
May
-10
Jun
-10
Jul-
10
Au
g-1
0
FISCAL YEAR 09/10
18,022 clients
CLIENTS ON HAART
72%
83% 81% 79%
87%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2006/07 2007/2008 2008/2009 2009/10 April 2010 -
August 2010
CLIENTS ON HAART
Source: ADAP database. * Total number of clients as of August 2010.** Please note that we have considered HAART treatment as clients on at least 3 anti-retrovirals from at least 2 different drug classes.
FloridaADAP
Trends Affecting ADAP
ADAP Clients on ART Treatment
PROGRAM GOAL
NUMBER OF CLIENTS WITH SUPPRESSED VIRAL LOAD
(≤ 75 copies/ml)
31%
38%
49%
56%
68%70%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2004/2005 2005/2006 2006/2007 2007/2008 2008/2009 2009/2010
Source: ADAP database. Reported on March 29, 2010.
FloridaADAP
R.A.M.P MONTHLY ENROLLMENTS
3,603
3,285
2,7852,733
28512,931
2,735
368
2385
1915
1467
818
-
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Mar-10
Number of clients eligible for RAMP
Number of clients enrolled in RAMP
Source: ADAP database. Reported on April 14, 2010.* Total number of clients enrolled in open status during the given timeframe. – note that number varies according to month.
FloridaADAP
Trends Affecting ADAP
HIV TESTS
330,639373,102 395,299
10,000
100,000
1,000,000
2007 2008 2009
FloridaADAP
Trends Affecting ADAP
AIDS INSURANCE CONTINUATION PROGRAM
Cumulative Wait-List
70
106124
141162
210
247267
308
353
390
416
0
50
100
150
200
250
300
350
400
450
Jul-Oct
O9
Nov-09 Dec-09 Jan-10 Feb-10 Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10
FloridaADAPTrends Affecting ADAP
FloridaADAPTrends Affecting ADAP
11,128
18,022
15,56914,396
1081 1589 1731 1894
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2007/08 2008/09 2009/10 as of 9/23
>350
Clients New to ADAP
CD4 between 350 and 500 cells/mm3
*Waiting List implemented June 1, 2010
33
5
30
1
33
0
31
7
29
7
36
7
26
8
35
7
37
2
35
7
37
6
36
7
39
4
1,9
09
2,1
15
33
1
1,7
04
1,5
60
1,5
21
1,6
62
1,6
62
1,8
24
1,7
65
1,5
59 1,9
83
1,6
46
1,7
76 2,2
15
2,276
2,509
2,0351,895 1,822
1,992 1,9792,121 2,132
1,827
2,340
2,0182,133
2,591
0
500
1,000
1,500
2,000
2,500
3,000
Ap
r-0
9
May
-09
Jun
-09
Jul-
09
Au
g-0
9
Sep
-09
Oct
-09
No
v-0
9
De
c-0
9
Jan
-10
Feb
-10
Mar
-10
Ap
r-1
0
May
-10
New Enrollments Recertifications Enrollments
2009/2010 MONTHLY ENROLLMENTS
(RW FY April 1st thru March 31st
)
FloridaADAP
Trends Affecting ADAP
ADAP ANNUAL ENROLLMENTS
Source: ADAP database. Figures shown reflect clients in open status anytime during the given year. Report released on July 2, 2010.
FloridaADAP
15,732
14,39615,569
18,022
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
2006/2007 2007/2008 2008/2009 2009/2010
Trends Affecting ADAP
ADAP FUNDING & CLIENT ENROLLMENTS
Source: ADAP database. Figures shown reflect clients in open status anytime during the given year. Report released on July 2, 2010.
FloridaADAP
$88,022,839
$83,621,697$83,509,558$83,621,697
15,732
14,396
15,569
18,022
$81M
$82M
$83M
$84M
$85M
$86M
$87M
$88M
$89M
FY06/07 FY07/08 FY08/09 FY09/10
-
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
FEDERAL ALLOCATION CLIENTS ENROLLED
State Funding $10.5M $10.5M $10.5M $9.5M
Fe
de
ra
l F
und
in
g
Clie
nt E
nro
llm
en
ts
Trends Affecting ADAP
Ryan White FY 2010-2011 Funding for ADAP
FloridaADAP
Trends Affecting ADAP
Ryan White $ 85,188,435
General Revenue $ 9,500,000
Total $ 94,688,435
Ryan White (Pharmaceuticals) $ 74,221,505
General Revenue (Pharmaceuticals) $ 9,500,000
ADAP Pharmaceutical Contracts:
Miami$ 3,241,945
Insurance Continuation (AICP) $ 2,683,311
Administration $ 5,041,674
Total $ 94,688,435
SHORTFALL RELIEF
$6.9 mil
(6%) SUPPLEMENTAL
$2.2 mil
(2%)
PART B SWEEPS
$1.7 mil
(1%)
STATE FUNDING
$9.5 mil
(8%) RW PART B
$75.6 mil(65%)
MIAMI CONTRACTS$3.5 MIL
GAP$18-19 mil
(16-17%)
FloridaADAP
Trends Affecting ADAP
Reported on September 23, 2010.
$0
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
$7,000,000
Prior to 2010 SAVINGS COST AS OF
2011
Future Trends Affecting ADAP
TrOOP: Medicare Cost Savings
FloridaADAP
Example: 593 Clients
6,4
04
,4
00
4,3
18
,0
9
2,0
86
,3
07
50%
15%
20%
13%
3%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
≤ 1 0 0 %
1 0 1 – 1 3 3 %
1 3 4 – 2 0 0 %
2 0 1 – 3 0 0 %
3 0 1 – 4 0 0 %
FloridaADAP
Point/CounterPoint
FPL: MEDICAID EXPANSION
Clients Enrolled 11,128
Source: ADAP Database. Reported on September 22, 2010.
PERCENTAGE OF CLIENTS AS OF 9/23/10
50%
15%
MEDICAID 2014
65%
FloridaADAP
Point/CounterPoint
Rule 64D
Client Enrollment Based on FPL
Source: ADAP Database Open Clients as of 9/27/10
5466
1623
2174
1456
232114
20
1000
2000
3000
4000
5000
6000
≤ 100% 101 – 133 134 – 200 201 – 300 301 – 350 351 - 400 >= 401
Nu
mb
er
of
Cli
en
ts
FPL %
FloridaADAP
Point/CounterPoint
Cap On Drug Expenditures
Source: ADAP Database, clients in open status as on 9/27/10 , with at least 1 pick in August 2010
6080
55%
3593
32%
994
9%313
3%84
1%
64
1%
0
1000
2000
3000
4000
5000
6000
7000
<$10,800
$10,801-15,000
$15,001-20,000
$20,001-25,000
$25,001-30,000
>$30,001
FloridaADAP
Point/CounterPoint
Medical Eligibility Criteria
CD4 Counts
5185
(47%)
2494
(23%)
788
(7%)
1234
(11%)
1366
(12%)
0
1000
2000
3000
4000
5000
6000
≤ 200 201 -300 301 -350 351-500 ≥ 501
Source: ADAP Database 9/27/10
FloridaADAP
Point/Counter Point
Recertification
27
FloridaADAP
Source: ADAP Database. Reported on August 30, 2010.
Future Trends Affecting ADAP
• Changes to the Eligibility Manual
• SOAR Training
• Medicaid FMMIS Training
Eligibility Screening
FloridaADAPPoint / Counter-Point
FloridaADAP
Source: ADAP Database. Reported on August 30, 2010.
CD4/CD8
Viral Load Testing
Labs
ADAP clients are permitted up to four (4) HIV Viral Load laboratory
Tests and four (4) CD4/CD8 laboratory tests a year through the
DOH, Bureau of Statewide Laboratories.
Reduce CD4 and Viral Load Tests
ADAP clients are permitted a Tropism (Trofile™) Assay laboratory
test (with approval from the medical unit in the Bureau of
HIV/AIDS).
Discontinue Tropism (Trofile™) Assay
Point / Counter-Point
30
FloridaADAP
Source: ADAP Database. Reported on August 30, 2010.
Point / Counter-Point
Eliminate Exception Requests (Pregnant Women Continue to be exempted)
Institute Asset Caps
Eliminate provision of drugs in Jails
Enforce Policy for Closures (No Grace Periods)
Overdue for pick-ups
Overdue for Enrollment
Proposed Cost Containments
31
FloridaADAP
Proposed Cost Containments
Source: ADAP Database. Reported on August 30, 2010.
Point / Counter-Point
Clients W/ Unaffordable Co-
pays and Deductibles
Pre-existing Conditions
Medicaid Share of Cost
Last on – First off
AIDS Drug Assistance
Program
Improving Health. . . Promoting Wellness
Lorraine Wells 7/7/2010
