ADAP - Purpose, Background & Population Served
The New York State Department of Health AIDS Institute has established four programs for HIV Uninsured Care (ADAP, ADAP Plus, the HIV Home Care Program, and the ADAP Plus Insurance Continuation Program). The mission of these programs is to provide access to medical services and HIV medications for all New York State residents with HIV/AIDS. The programs employ a dual approach to carry out their mission. First, the programs empower the individual to seek and access care by providing an "Enrollment Card", which allows the individual to choose a provider and receive care/drugs without cost. Second, the programs supply a stable and timely funding stream to health care providers, enabling them to use the revenues to develop program capacity to meet needs of the uninsured HIV population.
The AIDS Drug Assistance Program (ADAP) began in 1987 as part of a national program to provide free HIV/AIDS drugs to low-income individuals not covered by Medicaid or adequate third-party insurance. ADAP has grown tremendously in both enrollment and drug coverage. In November 1991, the HIV Home Care Program, modeled on ADAP, was implemented. This initiative was administered by the AIDS Institute's Chronic Care Unit until March 1993 when it was integrated with ADAP operations. ADAP Plus was developed as a unique partnership between New York City and New York State. In October 1992, ADAP Plus began operations. In July 2000, the ADAP Plus Insurance Continuation Program was implemented. All four programs are centrally administered, use a unified application form and coordinate outreach activities.
The programs serve HIV-infected New York State residents who are uninsured or under-insured and meet established criteria. The programs can serve as a transition to Medicaid by providing interim assistance to persons eligible for but not yet enrolled in Medicaid, or assist in meeting spenddown requirements. Individuals with third-party insurance who cannot meet the deductibles or co-payments, or whose policies have waiting periods, may enroll and programs will coordinate participant benefits with those of their insurance company. Adolescents who do not have access to the financial or insurance resources of their parents/guardians are eligible for the program. ADAP's demographics have changed over the years to reflect changes in the epidemic. Since the program began, there has been increased enrollment of African-Americans, Hispanics, women, low-income people and released prisoners.