Meeting of the
PRIORITY SETTING & RESOURCE ALLOCATION COMMITTEE
Monday, April 13, 2026
By Zoom Videoconference
3:05 – 3:55pm
DRAFT MINUTES
Members Present: Marya Gilborn (Co-chair), Paul Carr (Co-chair), Raffi Babakhanian, Matt Baney, Joan Edwards, Billy Fields, Camila Gomez, David Klotz, David Martin, Marcelo Maia, Scott Spiegler (for Guadalupe Dominguez Plummer, ex-officio), Stella Safo, MD, John Schoepp, Diane Tider
Staff Present: Michael Navejas, Johanna Acosta, PhD, Laura Moya Adames, Abraham Omeyoma (DOHMH); Arya Shahi (Public Health Solutions); Julie Vara (NYSDOH AIDS Institute)
Agenda Item #1: Welcome/Introductions/Minutes
Ms. Gilborn opened the meeting, followed by introductions and a moment of silence. The minutes of the February 2, 2026 meeting were approved with no changes.
Agenda Item #2: GY 2026 Reprogramming Plan
Mr. Klotz presented the draft GY 2026 reprogramming plan. The draft plan, identical to previous years, gives the Recipient the authority to move funds between service categories to make one-time enhancements to overperforming programs up to 20% of a service category’s original allocation. ADAP would absorb any remaining funds after all other program enhancements have been exhausted. This allows the Recipient to maximize spending during the grant year and keep underspending as low as possible. (A carryover plan for funds left unspent at the end of GY 2025 will be developed by the PSRA Committee in June.)
A motion was made and seconded to approve the GY 2026 reprogramming plan as presented. The motion was adopted 12Y-0N.
Agenda Item #3: ADAP Update
Ms. Vara, Director of the NYS HIV Uninsured Care Program (HUCP), gave an update on the State’s ADAP program. 24000 people are enrolled in ADAP statewide (72% from NYC), with 17500 of those active clients. HUCP is fully aware of issues facing ADAPs across the country, including increased drug costs, higher insurance premiums, Part B being flat-funded nationally since 2014, and since the enactment of HR1, changes to Medicaid and the Affordable Care Act essential plan. HUCP anticipates that there will be an increase in enrollment, including some people from other states that might move to NY to get care. Unlike some other states, HUCP is not looking at cost cutting, but rather cost savings strategies.
As ADAP is payor of last resort, HUCP is vigorously pursuing moving eligible clients to other coverage. Many ADAP participants are on “full pay” and do not have comprehensive health care coverage. About 2000 clients are eligible to move to a plan that provides comprehensive coverage. HUCP started a unit with trained staff to identify health care options and enroll clients in other markets. They are preparing for open enrollment, with a focus on ARVs, proactively reaching clients, spending considerable time and effort since last November enrolling hundreds of people into comprehensive coverage (incl. Medicaid, Medicare, ACA plans and private insurance). The program is trying to get the message out to people that this both an advantage to them and helps sustain the program. HUCP is reminding ADAP clients that the Insurance Continuation Program (APIC) can pay premiums, co-pays and deductibles. Currently, ADAP is paying $4400/month for Biktarvy (which 61% of enrollees use). If HUCP pays a client’s insurance premium, co-pay and deductible, there would be over $2400 in savings per month. The ADAP budget is now $529M for drugs alone. Moving clients to comprehensive coverage is the main strategy for NYS to avoid reducing the formulary or lowering eligibility.
A summary of the discussion follows:
- ADAP received rebates quarterly through the 340b program.
- HUCP covers clients regardless of immigration status and is especially important for undocumented people who are not eligible for Medicaid or ACA marketplace plans (it is also more expensive for them to get coverage through an insurance broker). There is no public charge issue for ADAP, and there is a focus on this population to ensure confidentiality and safety.
- The ADAP budget comes from RW Part B, RW Part A, the NY State budget, and 340B rebates.
- APIC can pay for Medicare Part D and any other plans that cover prescriptions.
- While there is no need for advocacy on the federal level yet, Ms. Vara is on the NASTAD task force, which keeps track of Part B-related issues.
Ms. Vara emphasized that NYS is prepared and has been planning for a long time. The program is not changing the eligibility (currently 500% of federal poverty level) or formulary.
Agenda Item #4: PSRA Committee Workplan
Mr. Klotz reviewed the workplan for the remainer of the planning cycle. In May, the Recipient will present a cost analysis for new Food & Nutrition programs that start GY 2027 to inform GY 2027 spending plan. CHAIN will present on Barriers to Care for Mental Health, Food and Nutritional Counseling (follow up to 11/25 presentation on Unmet Need and Utilization), to inform the PSRA Ranking Tool’s Needs/Gaps criterion.
In June, the Committee will consider the GY 2025 into 2026 Carryover Plan and begin work on the GY 2027 Application Spending Plan. In July, the Committee will finalize the GY 2027 Application Spending Plan, which allows the EMA to request 5% more than the current award (the EMA is still waiting for the full 2026 award).
The next Committee meeting will be on May 11th.
There being no further business, the meeting was adjourned.
