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Ryan White funding delays ‘resolved’ for AIDS groups

Baltimore reduced client services; Whitman-Walker ‘weathered’ crisis

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Don Blanchon

‘We got hit pretty hard,’ said Don Blanchon, of Whitman-Walker Health. (Washington Blade file photo by Michael Key)

A delay in the disbursement of federal Ryan White AIDS funds earlier this year that forced some community-based groups to reduce their services to people with HIV and AIDS appears to be resolved, according to officials with Baltimore and D.C. groups hit hard by the funding delays.

Tom Bonderenko, executive director of Moveable Feast, a group that provides meals for homebound people with HIV/AIDS in the Baltimore area, said his group hopes to resume full services to about 370 of its 1,200 clients that faced meal delivery cutbacks due to the funding delays.

“On this past Friday we did receive a reimbursement from the Baltimore City Health Department for some of our outstanding reimbursable funds,” he said on Wednesday. “Although we are still in a decrease service scenario for our clients, that will be adjusted in the next few weeks.”

Moveable Feast was among hundreds of community-based AIDS service organizations throughout the country adversely affected by federal AIDS funding delays initially caused by Congress taking far longer than usual to approve the federal budget for fiscal year 2011.

The city health departments in D.C. and Baltimore, which normally receive the Ryan White AIDS funds and pass them on to the community groups, reduced their previously approved grants to these groups earlier this year when they could not determine when the federal funds would be disbursed.

D.C.’s Whitman-Walker Health and the D.C. group Metro Teen AIDS were among the groups encountering problems from the funding delays.

According to officials with AIDS organizations affected by the delays, including Whitman-Walker Health, a miscalculation in Ryan White funding allocations for various cities and states by the federal agency that disburses federal AIDS funds created further delays.

The U.S. Department of Health and Human Services’ Health Resources and Service Administration (HRSA) acknowledged last month that the delays could adversely impact as many as 500,000 people with HIV and AIDS throughout the country.

HRSA spokesperson Marty Cramer told the Blade Wednesday the funding calculation problem has been resolved and HRSA is now forwarding the federal funds to cities and states, including D.C. and Baltimore.

“The situation is resolved,” he said. “The funding is out.”

Bonderenko said the funding delays forced his organization to reduce the number of meals it provides to its clients.

Last week, he said he was hopeful but uncertain that HRSA would soon disburse the funds to the Baltimore City Department of Health, which, in turn, would reimburse Moveable Feast for services it has provided to AIDS patients under a city contract.

“Basically, we are out of money,” Bonderenko told the Blade last week. “We won’t be able to assist 370 clients who depend on our service for their meals.”

Don Blanchon, executive director of Whitman-Walker Health, said his organization has also faced delays in receiving Ryan White funds for various HIV-related services it provides for low-income HIV/AIDS patients.

Blanchon said internal structural changes that Whitman-Walker made several years ago have enabled it to receive reimbursement for its services from patients eligible for Medicaid and for private health insurance coverage.

“We got hit pretty hard,” said Blanchon, who noted that the D.C. Health Department’s AIDS administration reduced its grants to community-based AIDS organizations due to the congressional budget delays and HRSA problems.

But he said Whitman-Walker now has a “diversified funding stream” that allowed it to use income from other sources to “weather this” without having to cut any of its programs or services to its clients.

Other organizations don’t have those other funding streams and they may be forced to cut back on services to their clients, Blanchon said.

Craig Shniderman, executive director of D.C.’s Food and Friends, a much larger group than Moveable Feast that provides meals for people with HIV and other serious illnesses in the D.C. area, said that similar to Whitman-Walker, his group was able to absorb the funding delays and continue its services without interruption.

“During the first half of the Ryan White grant period (March-August 2011) we experienced a very slight delay in receipt of our D.C. and Maryland Ryan White Funds,” Shniderman said. “However, this did not impact our ability to provide services insomuch as other funds available to us permitted Food and Friends to avoid any disruption in care,” he said.

Bonderenko and Blanchon said HRSA officials told leaders of AIDS groups like theirs in a telephone conference call in August that it expected to disburse all of the delayed funds in September. They said that during the same call, the HRSA officials acknowledged making a miscalculation in the allocation of Ryan White funds to states and cities, requiring them to take more time to recalculate the figures.

Bonderenko said Moveable Feast struggled to use its own money to continue its programs while waiting for the federal funds to arrive.

“We basically have carried the federal government for three months,” he said. “There are hundreds of providers in this same position.”

 

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Health

Gilead awards $5 million grant to HRC’s HIV and health equity programs

Money to support efforts to end the epidemic and combat stigma

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Human Rights Campaign headquarters in D.C.(Washington Blade photo by Michael Key)

The Human Rights Campaign was awarded a $5 million grant from drugmaker Gilead Sciences to expand the organization’s HIV and health equity programs, supporting efforts to end the HIV epidemic by 2030 while combatting stigma in Black and Latino communities.

Funds will be used over the next three years for the HRC Foundation’s HIV and Health Equity Program, its Historically Black Colleges and Universities Program, and its Transgender Justice Initiative, HRC said in a statement Wednesday announcing receipt of the award, which extends Gilead’s $3.2 million grant to the HRC Foundation in 2021.

The organization said its HIV and Health Equity Program plans to develop a “benchmarking tool for institutions that provide HIV services, helping better evaluate the quality of care and measure racially and socially inclusive approaches” while defining “best practices, policies and procedures to optimize HIV service provision for BIPOC LGBTQ+ communities.”

HRC President Kelley Robinson said, “Since the beginning of the HIV epidemic, racism and anti-LGBTQ+ discrimination have created dangerous hurdles for those seeking prevention or treatment.”

“With the generous support of Gilead Sciences, we’ll be able to continue providing critical
resources to help overcome these hurdles, especially focusing on Black and Latine communities in the U.S. South,” Robinson added. “We’ll also be able to expand our efforts, as we seek to remove institutional barriers often unknowingly created by HIV service providers. We must decrease the disparities that place an unnecessary burden on Black and Latine LGBTQ+ people and people living with HIV.”

Gilead Executive Vice President of Corporate Affairs and General Counsel Deborah Telman said the company “is committed to advancing health equity, particularly in Black communities and other communities of color that are disproportionately affected by HIV.”

“This grant will build on the impactful work HRC has done with community partners and HBCUs to increase awareness of HIV treatment and prevention options and reduce health disparities, combat discrimination and fight stigma,” Telman said.

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Health

New CDC data shows HIV infections dropped, but mostly among whites

Socioeconomic factor into disproportionate rates

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Data published Tuesday by the Centers for Disease Control and Prevention shows a significant decline in new HIV infections, but suggests the impact of prevention efforts was far less substantial for Black and Latino populations.

From 2017-2021, as rates of HIV testing, treatment and the use of pre-exposure prophylaxis (PrEP) medication rose, new cases dropped by 12 percent overall and by as much as 34 percent among gay and bisexual males aged 13-24.

The numbers show a “move in the right direction,” CDC Director Rochelle Walensky said in a press release.

However, when broken down by race, the CDC found new infections were down by 27 percent and 36 percent, respectively, among Black and Latino populations, compared with 45 percent of whites.

Similarly, by 2021 about one third of those who are considered eligible were taking PrEP for HIV prevention, but the CDC noted this number includes “relatively few Black people or Hispanic/Latino people” despite the significant increase in prescriptions up from just 13 percent in 2017.

“Longstanding factors, such as systemic inequities, social and economic marginalization and residential segregation,” Walensky noted, continue to act as barriers “between highly effective HIV treatment and prevention and people who could benefit from them.”

She added, “Efforts must be accelerated and strengthened for progress to reach all groups faster and equitably.”

Robyn Neblett Fanfair, acting director of the CDC’s Division of HIV Prevention, said that “At least three people in the U.S. get HIV every hour — at a time when we have more effective prevention and treatment options than ever before.”

“These tools must reach deep into communities and be delivered faster to expand progress from some groups to all groups,” she said.

The HIV+Hepatitis Policy Institute issued a press release following the CDC’s announcement of the new data, noting both the encouraging progress and need for improvement.

“It appears that our investments in HIV prevention are providing some positive results, but the persistent high number of new diagnoses and the low usage of PrEP among the communities most impacted by HIV point to the need for increased resources, particularly for a national PrEP program,” said the group’s executive director, Carl Schmid.

President Joe Biden’s FY24 budget requested $237 million for a national PrEP program along with $850 million to support the U.S. Department of Health and Human Services’ “Ending the HIV Epidemic in the U.S.” initiative.

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Health

Officials eye mpox prevention, vaccination initiatives for this summer’s LGBTQ events

New cluster of cases reported in Chicago

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Drs. Robert Fenton and Demetre Daskalakis, coordinator and deputy coordinator for the White House national mpox response, during a briefing in August 2022 (Official White House Photo by Cameron Smith)

Federal health agencies, in coordination with their state and local counterparts and community partners, are exploring opportunities to offer mpox prevention initiatives and vaccinations at LGBTQ events this summer, Dr. Demetre Daskalakis said on Thursday.

Daskalakis, the deputy coordinator for the White House’s national mpox response, described these deliberations in response to a question from the Washington Blade during a media telebriefing on mpox that was hosted by the Centers for Disease Control and Prevention.

The CDC on Monday issued a Health Alert Network Health Update on the potential risk for new mpox cases.

Since the peak of about 460 cases per day in August 2022, new cases have steadily declined, but following the cluster recently reported in the Chicago area, the update warns, “spring and summer season in 2023 could lead to a resurgence of mpox as people gather for festivals and other events.”

“We have the vaccine, and we have organizations that are willing to do it,” Daskalakis said during Thursday’s call, adding that resources are available and can be deployed flexibly because they are built into existing “HIV and STI funding to allow for this work.”

And the Mpox Crisis Response Cooperative Agreement, Daskalakis said, “provides even more resources locally for such efforts.”

Daskalakis and CDC Mpox Response Incident Manager Dr. Christopher R. Braden also briefed reporters on findings from new studies on the efficacy of the JYNNEOS vaccine for the prevention of mpox.

That data, per the CDC’s Morbidity and Mortality Weekly Report, reveals that “Among gay, bisexual, and other MSM and transgender adults aged 18-49 years, two doses of the JYNNEOS vaccine were 86 percent effective against mpox, indicating substantial protection against mpox.”

Additionally, “All routes of vaccine administration provided similar protection.”

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