Sunday, May 18, 2025
5/18/2025
ADAP Shortfall Relief - Description of Proposed Project: Wisconsin’s Communicable Disease Harm Reduction Section (CDHR) in the Division of Public Health, Department of Health Services, will use $5,000,000 in AIDS Drug Assistance Program (ADAP) ADAP Emergency Relief Funds (ERF) to address a projected increase in treatment needs due to increases in medication costs and in numbers of clients using Wisconsin’s ADAP and to address a reduction in available resources to fund ADAP due to delayed and decreased pharmaceutical rebate payments. In September 2024, 1,653 people living with HIV received Wisconsin ADAP services. ADAP ERF funds will augment ADAP services by directly paying for medications for the record number of clients using Wisconsin’s ADAP for medication assistance and ensure continued access to ADAP without waiting lists, enrollment caps, or reductions in the ADAP formulary. Wisconsin anticipates using ADAP ERF to provide medications to 255 uninsured clients in fiscal year 2025. As the number of clients enrolled in the ADAP is expected to increase by over 300 clients by the end of program year 2025, the ADAP ERF award will help ensure continued ADAP services without waitlists or enrollment caps. General Demographics of Wisconsin: 5.8 million people live in Wisconsin in 2.5 million households. The median household income is $75,000 and 10.7% of the population has household income below the federal poverty level. 4.9% of people lack health care coverage. Demographics of Populations Living with HIV in Wisconsin: In calendar year 2023, 252 people in Wisconsin were diagnosed with HIV. In addition, 219 people previously diagnosed with HIV moved to Wisconsin from other states, and another 64 people who received an HIV diagnosis in another country moved to Wisconsin. These numbers bring the total number of people known to be living with HIV in Wisconsin to 7,402 at the end of 2023, with an estimated additional 1,077 people who are living with HIV and have not yet been diagnosed. Wisconsin’s 2023 HIV diagnosis incidence rate was 4.4 per 100,000 people, an increase of 19% from the 2019 rate of 3.7 diagnoses. Description of State ADAP and Key Environmental Factors Impacting the Program: Wisconsin’s ADAP provides medication and insurance assistance for people living with HIV who reside in Wisconsin and have household income at or below 300% of the federal poverty level. For clients without health insurance, ADAP will pay the full cost of medications on the ADAP formulary, which includes antiretroviral (ARV) medications and limited categories of other medications. For clients with health insurance, ADAP will pay insurance premiums associated with group and individual health insurance plans that include prescription drug coverage as well as deductibles, co-insurance, and co-payments for ADAP formulary medications. In calendar year 2023, Wisconsin’s ADAP served 1,775 clients during at least part of the year. 88% of clients were virally suppressed. ADAP enrollment is currently increasing at an unprecedented rate, with particularly high numbers of people without health insurance applying for the program. ADAP is also experiencing record high medication costs for both insured and uninsured clients. Description of the Need for Additional Resources: By March 31, 2025, Wisconsin anticipates the number of clients using ADAP to increase by 300 clients to 1,950. In addition, medication costs for both insured and uninsured clients are expected to continue to increase. Due to these factors, Wisconsin estimates a $4.8 million shortfall for the ADAP program in program year 2025 if no additional funds are made available and will need to implement cost-cutting and cost-saving measures limiting access to the program to avoid a deficit. Description of the Planned Use of ADAP ERF: The CDHR plans to use $5,000,000 in ADAP Emergency Relief Funds to purchase 3,060 formulary prescription medications for 255 uninsured clients accessing ADAP services in fiscal year 2025.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).