Friday, April 4, 2025
4/4/2025
ADAP Shortfall Relief - Michigan demographics. More than 10 million people comprise Michigan’s population. Its poverty rate is 13.5% and the median household income is $69,183. The largest ethnic groups are White (73.5%), Black (13.4%), Multi-racial (3.7%), Asian (3.2%), and Hispanic (2.2%). Part A covers the Detroit Metropolitan Area, where 43% of Michiganders reside, but 63% of people with HIV (PWH) reside. Demographics of the populations with HIV. Michigan is classified as a medium-morbidity state for HIV infection. 18,437 PWH live in Michigan with 696 new cases in 2023. A majority of PWH are men of color and men who have sex with men (MSM). Substantial racial disparities exist. State ADAP and key environmental factors. PWH eligible for at least one Michigan ADAP service have a gross income under 500% of the Federal Poverty Level. The program uses an online portal to aid application processing and client enrollment. Clients have access to approximately 2,200 pharmacy locations including most chains and independent pharmacies. A partnership with a mail order pharmacy provides efficient service to enrolled clients at a significant savings to the program. As of September 30, 2024, ADAP is actively utilized by 3,443 PWH, which is more than 300 PWH served by ADAP during any year since 2020, and does not include persons who temporarily received services during this period. From January-June 2024, Michigan ADAP provided health insurance premium assistance to 791 PWH. Need. Michigan ADAP is confronting challenges associated with the changing ADAP landscape which stand to limit its ongoing ability to contribute toward EHE: • Reduction in available resources to fund ADAP due to projected decreases in rebate revenue in 2025 totaling more than $3.6 million due to policy changes affecting Medicare. • Projected increases in treatment needs aligned with EHE based on evidence that PWH who receive ADAP services in Michigan more often reach and maintain viral suppression than PWH who receive any Ryan White service or PWH who are not enrolled in Ryan White. Linear modeling forecasted a large gap in reach of ADAP reach. Costs are increasing for chronic disease management associated with an aging population. • Increased number of clients enrolled in Michigan ADAP due to the progress made in the Michigan HIV Continuum of Care especially among testing and linkage to care. Planned use of funds. To promote sustainable recovery from these unfavorable circumstances, and to enable progress toward EHE, MDHHS Bureau of HIV and STI Programs proposes to utilize ADAP Emergency Relief Funds to maintain current ADAP services for clients, enhance its generation of rebate, expand the ability to enroll clients in other payor sources, bridge gaps in alternative insurance coverage, and ensure its program efficiency. 1. V2023 American Community Survey, U.S. Census Bureau’s American Community Survey Office. Accessed 10/18/2024. 2. HIV Prevalence Report, 2023: Data as of April 2024. Michigan Department of Health and Human Services. https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Keeping-Michigan-Healthy/HIVSTI/Data-and-Statistics/2023/HIV-Prevalence-Report-Slides-2023.pdf. Accessed 10/09/2024.
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).