Priority Setting & Resource Allocation Committee Minutes March 18, 2024

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Meeting of the Priority Setting & Resource Allocation Committee

Monday, March 18, 2024

By Zoom Videoconference

3:05 – 3:50

Members Present: Paul Carr (Co-chair), Marya Gilborn (Co-chair), Raffi Babakhanian, Joan Edwards, Billy Fields, David Klotz, Matthew Lesieur, Guadalupe Dominguez Plummer, Claire Simon, Terry Troia  

Members Absent: Matt Baney, Kyron Banks, Steve Hemraj, John Schoepp

Staff Present: Doienne Saab, Scott Spiegler, Johanna Acosta, PhD, Adrianna Eppinger-Meiring, Kimbirly Mack, Jimmy Jaramillo, Patrick Chan (DOHMH); Barbara Silver, Arya Shahi, Rosemarie Santos (Public Health Solutions); Julie Vara (NYS DOH AIDS Institute)

Agenda Item #1: Welcome/Introductions/Minutes

Mr. Carr and Ms. Gilborn opened the meeting, followed by introductions and a moment of silence.  The minutes of the January 8, 2024 meeting were approved with no changes.  

Agenda Item #2: GY 2024 Reprogramming Plan

Mr. Klotz presented the draft GY 2024 reprogramming plan.  The draft plan, identical to previous years, gives the Recipient the authority to move funds between service categories to enhance overperforming programs up to 20% of a service category’s original allocation.  This allows the Recipient to maximize spending during the grant year and keep underspending below the 5% cap that would trigger a penalty for the EMA.  The money is a one-time, non-permanent enhancement that is usually done in the 3rd or 4th quarter.  

A motion was made and seconded to approve the GY 2024 reprogramming plan as presented. The motion was adopted 9Y-0N.

Agenda Item #3: ADAP Update

Ms. Vara presented on the NY State HIV Uninsured Care Program (UCP), which include four components: ADAP (prescription coverage), ADAP Plus (outpatient medical care), Home Care, and Insurance Continuation (APIC).  To be eligible, someone must be living with HIV, reside in NY State and have income below 500% of federal poverty level (the highest threshold in the country).  There is no asset test.  Enrollment and initiation of services is usually done on the same day that someone contacts the program.

Total enrollment is slightly under 25,000 with the number mostly stable for a decade.  There had been a slight increase during COVID, partially due to Medicaid stopping recertifications.  The program is monitoring for a possible uptick in enrollment due to new arrivals in the State, but has seen none yet.  The number of active clients has dropped slightly and the number of annual new enrollments is stable.  73% of all enrollees are from NYC and 4.3% from Lower Hudson (Tri-county) and over 80% of program expenditures are in NYC.  84% of all UCP expenditures are for medications, 10% for APIC and only 2% for operations.  64% of program resources come from recoveries, 29% from Part B, 4.3% from NY State and 2.8% from the NY EMA’s Part A contribution (down from over 4%).  98% of those in continuous enrollment are in care and 97% are virally suppressed.  

In response to questions, Ms. Vara explained that the program does not anticipate adding implants to its dental coverage, but are looking at adding other dental services.  When it comes to enrollment, the program does what is most cost-effective (e.g., helping a client keep their current insurance through APIC, rather than enroll in ADAP Plus, but covering co-pays).  There have been a number of additions to the ADAP formulary recently, including long-acting injectable ARV (Cabenuva).  The formulary is reviewed on a regular basis.

Mr. Klotz thanked Ms. Vara and the ADAP program for the long, effective partnership with the Council and RWPA program.

Agenda Item #4: Other Business

Mr. Klotz noted that the Committee has two items of business before the end of the planning cycle in July.  The GY 2023 into 2024 carryover plan will be done after the Recipient completes its closeout and knows the actual amount available for carryover.  Also, the Committee must approve a GY 2025 spending request for the grant application.  The EMA can request up to 5% more than the current year’s award.  The plan will be the blueprint for the actual spending plan in the fall-winter.  Data has been requested for service categories that are experiencing chronic underspending, often due to payor of last resort issues.  Ms. Plummer added that the funding amount needed for rental assistance and short-term housing will change due to the need to keep up with the federally determined fair market value.  More information will be presented at an upcoming meeting. There being no further business, the meeting was adjourned.