The Department's third ranked Exceptional Item Request is for HIV Medications. The request is for $3,986,216 in FY08 and $8,852,458 in FY09 ($12,838,872 total for the biennium). The requested amount would serve an additional 962 persons in FY08 and 1982 in FY09.
From the LAR draft:
At the end of 2004, there were an estimated 51,600 persons living with HIV/AIDS in the State of Texas. Federal funding for HIV services, prevention, and surveillance in TExas has continued to decline for the past three years. The funding request will allow the Texas HIV Medication Program (THMP) to continue providing life-saving medications to a growing number of clients with HIV disease whose incomes are at or below 200% of the federal poverty level. Resource needs are increasing because: (1) clients live longer because of effective treatment and stay on the program longer; (2) the number of people living with HIV disease increases each year; (3) the current medical standard results in clients taking a greater number of drugs; (4) newer, more effective drugs have come on the market at higher costs; and (5) older drugs continue to rise in cost at almost double the rate of inflation.
Once again, the DSHS Advisory Council's discussion took an ominous turn when this Exceptional Item Request was introduced. The word "ominous," in this case, does not imply anything sinister so much as "here we go again." Dr. Jaime Davidson, an endocrinologist from Dallas, raised the question of relative importance and relative funding. His question was based on the comparatively high request for HIV/AIDS versus the comparatively low request for obesity prevention. Tobacco use and obesity as causal factors for a number of expensive illnesses will cost the state a comparatively higher amount of money and affect a comparatively larger number of individuals--so the question came from an entirely reasonable point of view. However, as the Commissioner responded, there are increasing federal funds available to support these efforts while there is a decline in federal support for HIV/AIDS. The state, he said, was being called on for greater funding for HIV/AIDS because there were no other sources to fund this program while there are other "partners" that can be called upon for tobacco use and obesity prevention programs.
Texas AIDS Network will support this Exceptional Item Request. However, since the request will only provide for services at the current level without expanding or improving the Texas HIV Medication Program, we believe that additional funds should be requested. These funds could be used to expand the formulary to cover co-infection with Hepatitis C, better treatment for AIDS wasting, and begin to help with treatment of the side effects of HAART.
Once again, we recommend that concerned members of the HIV/AIDS community begin to meet with their state representatives and senators to discuss this request. At this time, we would recommend that this discussion be the focus of a second visit with legislators, following on an earlier meeting to discuss the restoration of the proposed 10 percent cut in funds for HIV/AIDS. We expect to have a specific recommendation for the additional funds needed for expansion and improvement within the next few weeks.