1. Louisiana ADAP Crisis

2. LA ADAP Crisis  Cost of providing meds through LA ADAP increased by 33%  Number of clients increased by 15%  At current rate of growth: Projection of $31.4 M is needed to maintain program through 2011  Health Resources & Services Admin (HRSA) awarded LA $17.7 M to serve 3,900 clients from Apr 2010 – Mar 2011  $17.7 M + $2 M (in pharmaceutical rebates) leaves LA with $11.7 M shortfall

3. Louisiana Office of Public Health Projected FY 2010 ADAP Expenditures Total Current ADAP Resources$19,682,500 Allocated for ADAP Administration$348,202 Allocated for ADAP Funding Co-Payments$1,040,000 Projected Need for ADAP Medications$30,000,000 Projected Need for Calendar Year 2010$31,388,202 Difference$11,705,702

4. LA ADAP Crisis  Potential shortfall of $11.7 million for FY 2010  Significant increases in client utilization costs without a corresponding increase in resources  Over 3,500 Low income Louisianans living w/HIV were served by ADAP in 2009  Over 3,500 will be impacted when cost containment measures are implemented

5. 1. Reduction and/or Elimination of some RW Part B Services 2. Capped New Enrollment 3. Application for FY 2010 RW Part B Supplemental Funding 4. Aggressive Efforts to Recoup Pharmaceutical Rebates 5. Request to the Ryan White Part A (NO) and TGA (BR) grantees for ADAP contribution LA ADAP Crisis: LA ADAP Crisis: Cost Containment Measures

6. LA ADAP Crisis: LA ADAP Crisis: Cost Containment Measure Over $2M Restriction on funding in other service areas:  Discontinuation of diagnostic laboratory - $492,000  Discontinuation of Primary Medical Services - $1,230,000 (CARES gives FACES $$ to UMC)  Discontinuation of local drug assistance, legal services, peer group support, and home health services - $774,450

7. LA ADAP Crisis: LA ADAP Crisis: Cost Containment Measure Cap new enrollment to LA ADAP  June 1, 2010  From 2007-09 new enrollments increased 67%  If new enrollments continued at same rate, a savings of $4,653,700 will result from cap

8. LA ADAP Crisis: LA ADAP Crisis: Cost Containment Measure Request to New Orleans and Baton Rouge for contribution  67% of LA ADAP clients receive services in NO or BTR; account for 63% of all LA ADAP expenditures in ’09  As a result, smaller regions suffer  No FACES caseload, no medication budget, no food pantry, significantly reduced other services

9. Contact Information Claude Martin Chief Executive Officer 337.233.2437 x125 337.704.0644 claude@acadianacares.org HIV/AIDS Program Office Dr. DeAnn Gruber Director (504) 568-7474 deann.gruber@la.gov Acadiana CARES