Ohio: AIDS patients win another round against state’s illegal restrictions on AIDS drug access

In News by AHF

After testimony from opponents of a proposed Ohio Department of Health rule change that would arbitrarily deny funding for potentially life-saving medications to Ohioans infected with HIV or suffering from AIDS-related symptoms that was presented during a Joint Committee on Agency Rule Review meeting today at the Statehouse in Columbus, ODH pulled the item to review for business impact analysis, among other procedural deficiencies

In November 2011, a judge granted preliminary injunction preventing the Ohio Department of Health from enforcing draconian changes regulations for Ohio’s AIDS Drug Assistance Program (ADAP); at another JCARR meeting earlier this year, AIDS advocates also succeeded in having the eligibility rule change pulled

COLUMBUS, OH (June 11, 2012) For the third time in the past six months, Ohio AIDS advocates and their supporters have succeeded in holding off the advancement of draconian changes to Ohio Department of Health (ODH) for the state’s AIDS Drug Assistance Program (ADAP) that would arbitrarily deny funding for potentially lifesaving medications to Ohioans infected with HIV or suffering from AIDS-related symptoms. Following powerful testimony from opponents of the proposed ODH rule changes that was presented during a Joint Committee on Agency Rule Review (JCARR) meeting today at the Statehouse in Columbus, ODH pulled the item to review for business impact analysis, among other procedural deficiencies.

In November 2011, after several Ohio AIDS patients filed a lawsuit opposing the legality of the rule change, a judge granted preliminary injunction preventing the Ohio Department of Health from adopting of enforcing the new regulations for Ohio’s ADAP; at another JCARR meeting earlier this year, AIDS advocates again succeeded in having the proposed eligibility rule change pulled from the agenda.

“We are thrilled that this item was pulled from JCARR’s meeting agenda earlier today,” said Eddie Hamilton, with the group, ‘ADAP Educational Initiative’ based in Columbus and who testified at the JCARR meeting today and who was also one of the plaintiffs in the November legal action. “The proposed rule changes would permit the Director of the Ohio Department of Heath to unilaterally lower the program’s financial eligibility guidelines to an income as low as 100% of Federal Poverty Level—just $11,000 annually—even though that same individual’s lifesaving HIV medications may cost $12,000 or more per year. From the beginning, state and DOH officials handled things poorly from a medical, legal and regulatory standpoint, by among other things, failing to hold required public hearings on the proposed changes. Not only are these rule changes bad medicine, they seem to be bad legally, and we will continue to oppose them on both grounds.”

“Changing Ohio’s medical-eligibility criteria for its ADAP, such as reducing the qualifying CD4 count from 350 down to 200, as this rule change would do, is actually a form of rationing of lifesaving HIV medicines,” said Tom Myers, General Counsel for AIDS Healthcare Foundation who also spoke at today’s JCAAR hearing. ‘This is not a cost-effective strategy for health officials, politicians—or Ohio taxpayers—as it is cheaper to prevent the progression of illness with medications than it is to pay for advanced illnesses that may require emergency room visits or hospital stays that come with far higher costs to the state down the road. We are thankful that the Ohio Department of Health had the good sense to pull this proposed rule change from the agenda of the Joint Committee on Agency Rule Review meeting earlier today to review it for business impact analysis, among other procedural deficiencies.”

The catalyst for the Ohio advocates’ initial legal action against the state back in November arose in late September 2011, when Ohio health officials took final steps to institute what are likely some of the most severe medical and financial-eligibility changes to a government medical assistance program nationwide— provisions that would have rationed health care in Ohio, and would have given the Director of the Ohio Health Department unilateral, arbitrary control over who does and who does not get ADAP.  The rule changes, which were scheduled to go into effect in early November, drastically reduced individuals’ eligibility for Ohio’s beleaguered AIDS Drug Assistance Program (ADAP), one in the national network of federal and state funded programs that provide life-saving HIV treatments to low income, uninsured, and underinsured individuals living with HIV/AIDS.

In issuing the temporary restraining order, the Judge wrote at the time that the “the public interest will be served” by issuing the preliminary injunction and concluded his ruling with the following three paragraphs:

“In considering whether the public interest will be served by issuing the preliminary injunction, this Court finds in the affirmative.  Plaintiffs, as well as numerous individuals with AIDS and HIV-related diseases, rely on medical treatments to survive.  Changes to the Ryan White Program will undoubtedly affect access to treatment.  Failure to grant an injunction without a hearing make Plaintiffs and other similarly situated individuals of being subject to the discretion of the ODH Director without any say on their behalf.

Additionally, this Court finds that the public interest is served by protecting the right of a public hearing.  If rule-makers are able to create rules without adhering to the legislative process then there is little incentive to follow the statutory process properly.  Failure to grant a permanent injunction in this case would invite statewide agencies to conduct meaningless public hearings only to substantially alter the rule at a later date.

Finally, the public has a vested interest in the Plaintiffs and other individuals with AIDS and HIV-related diseases because access to the medical treatment helps to ensure statewide health, wellness and a safer community.  There, this Court finds that Plaintiffs have met their burden in establishing that the public interest is served by the granting of this injunction.”

While Ohio’s proposed rule changes might appear to initially save the state some money in the short term, it ultimately would lead to far higher medical costs to the state as those disenfranchised AIDS patients became ill and seek emergency care at hospitals around the state—something far more costly and far less clinically appropriate.

 

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