Thursday, April 3, 2025
4/3/2025
ADAP Shortfall Relief - In 2023, the Commonwealth of Massachusetts had just over $7 million residents. 79.0% of residents were white (non-Latinx), 9.6% of residents were Black (non-Latinx), and 13.5% of residents identified as Latinx. Between 2018 and 2022, approximately 18% of the state’s residents were not born in the United States. 10.4% of the total population lived in poverty. In recent years the number of new HIV infections was dropping. However, in 2023, the number of new HIV infection diagnoses returned to pre-pandemic levels (n=540), increasing by 21% compared to the prior year. The number of people living with HIV in Massachusetts increased 11% between 2014 and 2023 because of longer life expectancy and HIV+ individuals moving into the state. HIV health inequities persist in the Commonwealth. Between 2021 and 2023, the average annual age-adjusted HIV diagnosis rates among Black (non-Latinx) individuals and Hispanic/Latinx individuals were 11 and five times that of White (non-Latinx) individuals, respectively. Between 2020 and 2022, 41% of all people diagnosed with HIV were born outside of the United States, when that population represented only 18% of Massachusetts residents in 2021. Additionally, individuals reported with an exposure mode of men who have sex with men (MSM) represented 39% of new HIV diagnoses. 47% of individuals assigned female at birth (AFAB) living with HIV are Black (non-Latinx). Massachusetts’ ADAP, here called the HIV Drug Assistance Program (HDAP), supports people living with HIV who are seeking assistance in covering the costs of their prescription medications, health insurance premiums, and co-payments. DPH subcontracts operation of HDAP to the non-profit organization Community Resource Initiative (CRI). DPH and CRI have collaborated in the administration of the program since 1990. In FY23, the HDAP program enrolled 5,518 clients with an average of 2,200 clients served monthly. HDAP is facing an emergent challenge posed by an increase in the cost of medications for HIV+ people as well as a rise in health insurance premiums. Simultaneously, state and federal funding is shrinking, and there is a projected loss in rebate revenue due to Medicare’s plan to cap out-of-pocket medication costs at $2,000 as of January 1, 2025. Despite implementing cost-containment measures, HDAP is unable to meet the growing demand for services with existing resources. HDAP has limited options to continue providing uninterrupted access to HIV medications. Massachusetts is requesting funding through ERF for the purchase of medications and the purchase of health insurance premiums. This funding will continue to ensure universal access to life-saving medications. If awarded, ERF funds would be used to: 1. Assist with the purchase of ADAP medications (amount of request: $2,060,679). Between grant year (GY) 2024 and GY25, full-pay expenditures for medications for HIV+ clients are projected to increase approximately $2.1 million. The average client cost for the purchase of full-pay medications per year will increase from a projected $8,240 in CY24 to a projected $11,244 in GY25. Through the ERF grant, DPH shall provide 138 HIV+ clients with 1,242 full-pay prescriptions during the measurement period. 2. Assist with the purchase health insurance premiums (amount of request: $1,044,746). Health insurance premium costs for HIV+ clients are projected to increase approximately $1.0 million between CY24 and GY25. Projections show that the average cost per client per year will rise from an estimated $4,970 in CY24 to $5,304 in GY25. Through the ERF grant, DPH shall provide 197 HIV+ clients with 2,167 premium payments to insurance companies during the measurement period. The total amount of the request is $3,105,425.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).