ADAP Shortfall Relief - ABSTRACT The Mississippi State Department of Health (MSDH), Office of STD/HIV, submits this proposal in response to HRSA NOFO HRSA-23-012: AIDS Drug Assistance Program (ADAP) Emergency Relief Funding (ERF). As the state’s public health authority and the Ryan White HIV/AIDS Program (RWHAP) Part B recipient, MSDH is committed to ensuring uninterrupted access to life-saving HIV medications and essential health services for low-income, uninsured, and underinsured Mississippians living with HIV. Mississippi faces persistent health disparities compounded by poverty, limited healthcare infrastructure, and high uninsured rates. The ERF will provide critical support to strengthen program capacity, prevent medication interruptions, and promote equitable access to HIV care and treatment statewide. The Mississippi ADAP operates as a payer of last resort and provides FDA-approved antiretroviral medications, health insurance premium assistance, and wraparound support services. Its integrated system includes program management, pharmacy benefit management (PBM), eligibility and enrollment, data reporting, and fiscal oversight units. The program maximizes limited resources through coordination with Medicaid, Medicare Part D, and private insurance, while leveraging rebates and cost-sharing strategies to sustain care. In FY 2024 and FY 2025, ADAP achieved cost savings through CAREWare data integration, digital document management, tele-enrollment, and improved coordination with Ryan White Part B and other state programs. The program also expanded eligibility from 400% to 500% of the Federal Poverty Level (FPL), allowing more Mississippians to access HIV treatment and insurance support. Despite these advancements, Mississippi’s ADAP faces challenges such as rising drug costs, funding uncertainty, and social drivers of health that limit access to care. ERF funds will enable the purchase of essential medications, payment of insurance premiums, and coverage of client co-payments and deductibles to prevent treatment gaps. Program monitoring will be conducted by MSDH’s Clinical Quality Management team through data-driven oversight of service delivery, medication adherence, and viral load suppression outcomes. The sustainability plan emphasizes continuous improvement through cost-containment, increased enrollment in other payer sources, enhanced data management, and partnerships to strengthen HIV care infrastructure. Through these coordinated efforts, MSDH aims to safeguard equitable access to treatment, sustain financial integrity, and advance Mississippi’s goal of ending the HIV epidemic.
