As NJ's HIV/AIDS population grows, advocates question shrinking state drug program

Source: Health
With the number of New Jersey residents with HIV expected to rise by 9 percent in the coming year, the leader of the state’s largest AIDS advocacy group is questioning why the Christie administration’s proposed budget expects far fewer will need a program that helps pay for their prescriptions.
There are 7,800 people enrolled in the AIDS Drug Distribution Program this year but Christie’s budget anticipates only 4,500 for the budget year that begins in July, a drop of more than 40 percent. At the same time, the number of people living with the deadly illness is expected to rise by about 3,400 to 42,210 — largely because of medical advances and an improved reporting system.
“How do you add more than 3,400 people living with HIV and AIDS and drop the number of people (in the program)?” said Kathy O’Brien, executive director of the New Brunswick-based Hyacinth AIDS Foundation. “It makes no sense.”
The administration expects the cost of the $101 million program to be paid for by the federal government and rebates from drug manufacturers, according to a budget analysis by the independent, non-partisan Office of Legislative Services. O’Brien said the Christie administration eliminated state financing for the program last year in anticipation of the federal assistance and rebates.

In 2010, Christie threatened to eliminate state funding for the program, but after an outcry from lawmakers and advocacy groups, he found federal money and manufacturers’ rebates so state aid could be phased out.

In a response to the OLS analysis, the Christie administration said it expected fewer people to need the drug program because some low-income recipients would qualify for Medicaid, which was expanded under the Affordable Care Act. It said those who earned too much to qualify for Medicaid could enroll in a plan offered through a health exchange created by the new health care law.
“This is about transitioning ADDP clients who are uninsured into health coverage through the Medicaid expansion,” said Donna Leusner, spokeswoman for the state Health Department. “We are working with stakeholders to ensure a smooth transition.”
Eligibility for the program is based on income, and is regularly monitored and checked every six months, Leusner added
O’Brien acknowledged that state agencies, hospitals and community groups like Hyacinth worked diligently to enroll people in Medicaid and Obamacare, but she said she didn’t know if anyone was aware how many people from the drug program were enrolled.
She added that federal grant programs were also cut by Congress and the Obama administration last year.
“There are cuts all around and nothing is stable,” O’Brien said. “I wouldn’t make any more cuts until there is more certainty.”
O’Brien pointed to a 2011 study lead by a University of North Carolina researcher that found anti-retroviral drugs cut HIV transmission rates in sexual partners by 96 percent.

That’s why the drug program is “critical — it’s one of the most important programs we have,” said O’Brien, whose organization receives about $1 million from the state. “It’s about finding people who are (HIV) positive and making sure they have access to these drugs.”

The success of anti-retroviral drugs is one reason why there are more people with HIV and AIDS in New Jersey. But another is the switch from a paper to an electronic reporting system that more reliably tracks test results, Leusner said. “It allows participating labs to transmit positive HIV lab tests on a daily basis,” she said.
There were 1,902 additional cases of HIV infection from July 2012 to June 2013, according to the most recent state Health Department information available. Of these cases, the most likely causes involve injection drug use (36 percent), heterosexual sex with people whose partner’s HIV status was unknown (26 percent), and men having sex with men (21 percent). The number of infections involving male homosexual partners is rising, however, according to the state.
The Health Department’s $1.8 billion budget came under scrutiny on Monday at a hearing of the Assembly Budget Committee.

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