The federal government announced June 6 a series of initiatives designed to help states pay for better-coordinated care for HIV/AIDS patients including expanded testing and more pharmaceutical therapies.
The announcements were timed to coincide with the 30th anniversary of the first U.S. case reports that signaled the beginning of the HIV/AIDS epidemic. All the initiatives are designed to help implement the National HIV/AIDS Strategy introduced by President Obama in July 2010.
That was the first-ever federal strategy to comprehensively address HIV/AIDS, said Health and Human Services Secretary Kathleen Sebelius in a press briefing. Ms. Sebelius said that the government is pressing ahead with prevention and treatment programs, as the epidemic continues to be a threat.
Since the early 1980s, "more than 600,000 Americans have died long before they should have," Ms. Sebelius said.
Some 56,000 Americans are infected with HIV each year and 1.1 million are living with HIV/AIDS, said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention (CDC), during the briefing.
The CDC is taking a close look at the resources it devotes to HIV/AIDS and restructuring how that money is spent, Dr. Frieden said. The agency will be making funds available to states to expand access to testing, in particular for men who have sex with men. That population is at highest risk for HIV infection; those men are also playing a big role in new infections, Dr. Frieden said.
The CDC also will be redirecting funds to help providers link HIV-positive patients to care and to help keep them in care, he said. "We know people in care are less likely to engage in risky behavior," Dr. Frieden said.
The agency also will be providing funds to state and local health agencies to more closely track viral load and CD4 counts in HIV-positive patients. The goal is to ensure that clinicians are keeping patients maximally suppressed and thus help reduce the risk of new infections, Dr. Frieden said.
States also will get a boost for their AIDS Drug Assistance Programs. The ADAP is administered by Health Resources and Services Administration (HRSA) as part of the Ryan White HIV/AIDS Program. Last July, HHS reallocated some $25 million for states to use to take people off waiting lists for ADAPs. In the current fiscal year (2010), HHS is making another $50 million available to states specifically to help take people off waiting lists, said HRSA Administrator Mary Wakefield during the briefing. That’s in addition to the $835 million HRSA already has allocated for ADAPs in fiscal 2010, she said.
Finally, the Centers for Medicare and Medicaid Services announced that it is giving states more flexibility in caring for HIV/AIDS patients on Medicaid. The agency sent a letter to state Medicaid directors explaining that they could apply for funding that would allow patients to be cared for at home or with community-based services. The agency is also going to make it easier for HIV-positive adults to receive Medicaid coverage, said Cindy Mann, director of the Center for Medicaid and State Operations, during the briefing.
Under the Affordable Care Act, beginning in 2014, all adults with incomes below 133% of the federal poverty level will be eligible for Medicaid. But many living with HIV do not have insurance or do not have incomes low enough to qualify for Medicaid currently, Ms. Mann said. So the agency is creating a fast track that will allow states to seek waivers specifically for their HIV/AIDS patients to receive Medicaid at that lower income level now, she said.