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ADAP 101

ADAP 101. Sharing Experiences - Passing the Baton Nancy Abraham-Budds, MPA. Historical Highlights:. Marker events for ADAP and important lessons learned Free AZT program started in 1987 1990 - Ryan White Care Act signed into law – but no allocation.

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ADAP 101

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  1. ADAP 101 Sharing Experiences - Passing the Baton Nancy Abraham-Budds, MPA

  2. Historical Highlights: Marker events for ADAP and important lessons learned • Free AZT program started in 1987 • 1990 - Ryan White Care Act signed into law – but no allocation. • 1991 – First RWCA grant to states and EMAs • 1992 Veteran’s Health Care Act, • 1993 National ADAP Advisory Panel

  3. Historic Growth

  4. Research Impacts Demand • 1994 Concord study – AZT doesn’t prolong life • 1995 Clinical Trials show success of combination therapy (HAART) • Clinical Trial – 076, Reduction in transmissibility • Lab Tests: CD4 (1985) & Viral load (1996) • Genotype, Phenotype, Trofile (Who pays for them?)

  5. Y2K – The Great Non-Event • Lessons learned to prepare for the unknown - • Contract language • Back-up Plan • Communication with CM, Providers, Clients, etc. • ___________________________________

  6. Funding Milestones • 1996 Major funding increases –ADAP Earmark. Cost-containments • 1998 - Increase as much as 35% in one year • Funding slows; view of HIV/AIDS changes • Set plans for Feast or famine

  7. From Feast to Famine • Waiting lists • Cut formularies, decrease income threshold, other cost containments • QA • Re-bid contracts • Know the industry and the bidders

  8. MEDICARE - D • Quick catch up – Who is eligible? • Train yourself first • Collaborations – Aging, Medicaid, SPAP, ALCC, AFC • Consistency of policy as payer of last resort • Survival…………………

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