The Texas Legislature granted the Texas HIV Medication Program $36.3 million, as lawmakers made finishing touches to the state budget Monday. The award comes after a series of financial woes during the pandemic left a more than $100 million budget deficit hanging over the program in the next two fiscal years.
"This is definitely a win, and we’ll take it," said Januari Fox, Policy Director of PRISM Health, a group of HIV clinics in Dallas.
The program covers the cost of life-saving drugs that have significantly reduced the spread of HIV in Texas. It’s facing a budget deficit after the number of Texans enrolled in the program grew about 30% in the past year, according to the Department of State Health Services (DSHS). Job losses in the HIV community have pushed more people off their health insurance and onto the state-run program.
A software glitch discovered by program administrators in June also added to the shortfall, concealing $35 million in drug costs.
"I think that we had a real problem going in (to the session) and everybody came together,” Fox said. “Advocates on the ground, people working with people living with HIV, DSHS and our elected officials, everybody came together to make sure that this program received the funding that it needed."
The $36 million from the legislature only closes part of the budget gap. DSHS originally asked lawmakers for nearly three times as much — $103 million — to clear the medication program's entire deficit and stave off the possibility of a medication waitlist.
In an email, a spokesperson said DSHS was able to lower the request by carrying forward unused funds, transferring funds within the department and other measures. The Department has also applied for federal funds.
"I think DSHS is taking a big risk by not going with the original number and really relying on those federal funds to come in," Fox said.
Advocates have feared that Texans living with HIV would lose access to life-saving medication after some were removed from the program in December. Many consumers and providers didn't find out until after the decision was carried out.
Advocates pushed legislators to require DSHS to provide 60 days advance notice for all stakeholders if something similar were to happen again.
"I think it’s a direct result of sort of feeling like they were kept in the dark, that we were all kept in the dark — providers as well," said Lindsay Lanagan, the Director of Government Relations at Legacy Community Health in Houston. "I think it’s a really good thing to provide notice to people that are going to be potentially affected and cut off of a program."
Program administrators have been actively trying to rebuild trust with the HIV community. They held a Town Hall meeting in March and launched a web page answering constituents’ questions.
But even as the program makes strides towards transparency and financial solvency, HIV survivor Stephen Vargas said many have one thing on their mind.
"Does this help us avoid implementing a waitlist?" Vargas said. "That’s always going to be my first question. I think that would be the worst thing that we could do."
There are other options for Houstonians living with HIV if the federal funds fail to come through, said Vargas.
"We have some workarounds that can help folks still get access to their meds, but I’m not sure if this exists in a rural area," Vargas said. "It still leaves a huge group of people living with HIV in Texas out."
A DSHS spokesperson said the Department will "continue to monitor the program to see if (a waitlist) may be necessary."