Wednesday, April 2, 2025
4/2/2025
ADAP Shortfall Relief - The proposed project will address the State of Minnesota’s revised rebate forecasting, which indicates that the amount of funding available for HIV services across the state will be significantly reduced, resulting in cuts both to the number of programs presently funded and the amount available for individual awards. At the same time, new HIV diagnoses in Minnesota reached a ten-year high in 2023 as the state continues to experience HIV outbreaks in Hennepin and Ramsey counties, as well as St. Louis County, among persons who inject drugs (PWID) who are experiencing homelessness or unstable housing. General demographics of the state U.S. Census data (2020) estimates Minnesota’s population at 5,706,494, an increase of 7.6% from 2010. Its most populous counties are Hennepin (1,281,565) and Ramsey (552,352). Approximately 83% of the population identifies as White alone or White in combination; 6.9% as Black or African American alone; 6.1% as Hispanic or Latino; and 2.8% as American Indian/Alaska Native alone or in combination. People aged 18 or older represent 77% of the population, compared to 23% who are younger than 18. Demographics of Minnesota’s HIV population In 2023, the Minnesota Department of Health reported 324 newly diagnosed HIV infections, a 24% increase from 2022. There are 5,767 (58%) persons diagnosed with HIV infection (non-AIDS) in the state, while 4,229 (42%) are living with an AIDS diagnosis. The highest concentrations of PWH live in the Twin Cities Metro area, 3,248 in the City of Minneapolis, 1,137 in the City of St. Paul, 3,694 in the surrounding suburbs, and 1,903 in Greater Minnesota. PWH in Minnesota sex assigned at birth: male 7,458, female 2,538. PWH in Minnesota by race: White, non-Hispanic persons 4,121, Black, non-African-born 2,038, Black, African-born 1,714, Hispanic persons, 1,254, and American Indians account for 120 cases. Two-thirds (66%) of new HIV cases affect communities of color. In 2023, Hispanic comprised 22% of new diagnoses, up from an average of 14% over the prior five years (2018-2022). Description of MN ADAP and key environmental factors impacting the program Program HH is housed and administered by the Minnesota Department of Human Services (DHS) within the HIV Supports Division (HSD). It includes several Ryan White Part B services (Mental Health, Dental Services, Medication Therapy Management Services and Nutrition Services) as well as ADAP. In 2022, DHS learned that variances in received rebates and program expenditures had led to significant changes in the resources available for HIV Supports in the upcoming fiscal years. There will also be a substantial cut to DHS’s ability to rebate on Medicare clients in 2025, as the Part D drug maximum out-of-pocket cost will be capped at $2,000. The loss of rebates due to changes in Medicare is projected to result in a reduction of up to $3.5 million, which could lead to more cuts to supportive services. At the same time, DHS is projecting a $3 million increase in ADAP/Health Insurance costs for the next grant year. Planned use of ADAP ERF The proposed funding will address medication access, utilization, and adherence while supporting improved health outcomes such as viral suppression and overall quality of life. Receipt of ADAP ERF funding will help cover expenses described in this narrative as DHS works on longer-term sustainable funding streams.
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).