Part A Minority AIDS Initiative (MAI)

Chrissy Abrahms Senior Policy Advisor Division of Metropolitan HIV/AIDS Programs HIV/AIDS Bureau Health Resources and Services Administration Department of Health and Human Services

Today

’

s Topics

• Overview of MAI Program • Background: Key Program Points • Questions & Answers

Part A MAI Program

OVERVIEW OF PROGRAM

What Prompted the MAI?

1996:

Protease inhibitors/HAART therapies approved

1998:

Data from the Centers for Disease Control and Prevention (CDC) showed that people living with HIV/AIDS (PLWH/A) were living longer… EXCEPT in minority populations

CDC data showed…

• Continuing disproportionate increases in HIV/AIDS cases among minorities • Disparities in access to care and treatment • Disparities in health outcomes

May–Sept. 1998

The Federal Response

October 1998 HIV/AIDS leaders worked with the Congressional Black Caucus to request that a state of emergency be declared. President Clinton declared HIV/AIDS in minority communities to be “ …a severe and ongoing health crisis.

” HHS initiative to address crisis with increased funds outreach During the annual appropriations process, Congress established the MAI with $156 million for five agencies, including $24.3 million in Ryan White funds ($5 million for Part A). HRSA CDC IHS NIH OMH SAMHSA Ryan White Program

Evolution of Part A MAI

• Established - 1999    Purpose: Improve access & HIV/AIDS health outcomes for minority populations $5 million initially Grantees: 51 Part A Grantees • 2000 - 2006 :   Funding increased from $26.5 million in 2000 to $42.9 million in 2006  7.4 percent of total Part A funds Purpose unchanged • • 2006 :    Codified into law as a separate, competitive grant program (2007 – 2009) All EMA ’ s and TGA ’ s applied and received funds Minimum/maximum awards 2009 Reauthorization :    Returned to formula funding Formula based on living HIV+ AIDS minority cases Synchronized with Part A program year

HIV Infections in Blacks/African Americans

Of the 197,090 diagnoses of HIV infection from 2008–2011, Blacks/African Americans accounted for: • • • • 47 percent of total number reported (12 percent of population) 64 percent of women reported 66 percent of the children < age 13 66 percent of infections attributed to heterosexual contact In 2011, 46 percent of diagnoses of HIV infection in adults and adolescents were Blacks/African Americans CDC Slide Set http://www.cdc.gov/hiv/library/slideSets/index.html

HIV Infections in Hispanics/Latinos

Of the 197,090 diagnoses of HIV infection from 2008–2011, Hispanic/Latinos accounted for: • • • • 21 percent of total (17 percent of population) 16 percent of women 15 percent of children < age 13 18 percent of infections attributed to heterosexual contact In 2011, 22 percent of diagnoses of HIV infection among adults and adolescents were Hispanics/Latinos CDC Slide Set http://www.cdc.gov/hiv/library/slideSets/index.html

MAI Funding 1999-Present

Part A Minority AIDS Initiative

KEY PROGRAM POINTS TO REMEMBER

• • • • In setting priorities for the use of ALL Part A funds, Planning Councils must: Determine the size and demographics of the local HIV epidemic Determine service needs, paying attention to:   Those who know their status but are not in care Disparities in access and services among affected subpopulations and historically underserved communities Establish methods to obtain input on community needs and priorities Consider capacity development needs resulting from disparities in the availability of HIV-related services in historically under served communities

HRSA Guidelines for MAI Providers:

• Located in or near the community to be served • Have a documented history of providing service to the targeted community(s) • Have documented linkages to the targeted populations, so that they can help close the gap in access to service for highly impacted communities of color • Provide services in a manner that is culturally and linguistically appropriate

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HRSA Guidelines for MAI Providers:

MAI funds must be separately tracked and reported on your Part A Federal Financial Report breakout of funds (i.e., they do not lose their separate identity)  Part A legislative requirements apply , for example:      Planning Council sets priorities for use of MAI funds Consider MAI funds in calculating Core Medical Services requirement Part A cost caps apply:    10 percent grantee administration 5 percent CQM 0 percent aggregate provider administrative costs Payer-of-last-resort Rules with respect to imposition of charges  Exception: Ryan White Unobligated Balances (UOB) Requirement. However, grantees must submit an approvable carryover request with their Part A FFR or within 30 days of submitting the FFR and be able to utilize the MAI funds within the next fiscal year.

Contact Information

Chrissy Abrahms Senior Policy Advisor (301) 443-1373 [email protected]