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Federal HIV funding rerouted to Tennessee nonprofits after state officials refused federal funds

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White House, United Nations call for resources to help end HIV/AIDS

The White House urged Congress to fund initiatives to increase the use of PrEP, a drug used to help reduce the spread of HIV.

Anthony Jackson, USA TODAY

Nearly three months after the Tennessee Health Department said it would no longer accept and distribute federal funding for HIV prevention-related services, the Centers for Disease Control and Prevention will now reroute some of the funding through a Nashville-based nonprofit organization.

The Commercial Appeal, part of the USA TODAY Network, obtained a letter of intent from the CDC to send $4 million in funding for HIV-services through the United Way of Greater Nashville. United Way will then disperse the federal funding to the organizations.

The amount is a little less than half of what the 2023 grants previously totaled — around $9 million.

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The move means the Tennessee Department of Health has been cut out of the process of distributing the dedicated federal funding meant for HIV prevention, surveillance, and treatment. The decision by the CDC is rare at a minimum, and possibly unprecedented.

Previously, United Way administered funds given to the state health department by the CDC. United Way would then distribute that funding to partner organizations like Planned Parenthood of Tennessee and North Mississippi, Choice Health Network, Friends for Life, and St. Jude Children’s Research Hospital, one of the largest providers of HIV care for children and young adults in the Mid-South.

In mid-January, several nonprofits that provide HIV services to mostly low-income Tennesseans learned from United Way of Greater Nashville that federal funds from the CDC would no longer go to organizations not affiliated with metro health departments.

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The federal grants have been distributed to the nonprofits for years, and the funds were often significant portions of the affected nonprofits’ budgets. The loss of this funding was estimated to impact roughly 20,000 Tennesseans, particularly in rural areas with limited access to healthcare resources.

The timing of the decision came mid-grant cycle for many of the organizations, and it left them scrambling for alternate funds that would make up for the sudden budget gaps.

Many of the affected organizations were based in West Tennessee and Memphis. The western part of Tennessee, particularly Shelby County, is one of the highest areas of HIV transmission in the U.S.

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Transmission of HIV is not limited by a state border. Advocates for HIV prevention said Tennessee’s decision to cut the federal funds also impacted rural areas that border other states.

After the initial news broke of the decision to decline federal funding, Tennessee Health Commissioner Ralph Alvarado told a state Senate committee the funding would be replaced with $9 million in state funding.

However, only a handful of organizations — mostly local health departments — out of more than a dozen affected organizations were guaranteed state dollars to make up for the cuts. Even then, that commitment was only verbal, and not guaranteed. Additionally, the state funding per organization would be contingent on a vote from Tennessee lawmakers.

With state funding, Tennessee’s state health department would have the ability to make decisions about which organizations would receive HIV-prevention dollars and therefore bypass CDC requirements — one of which said organizations like Planned Parenthood could not be refused funding.

In November 2022, Alan Schoenfeld, a Planned Parenthood of Tennessee and North Mississippi attorney, wrote that the state’s attempts to disqualify Planned Parenthood from the HIV funding and terminate a longstanding memorandum of understanding between the healthcare organization and the state health department were both unlawful and in violation of Planned Parenthood’s constitutional rights.

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The letter referenced a similar action to strip Planned Parenthood from federal funding in two separate attempts in 2012 and 2017. The later attempt occurred in Shelby County when former County Commissioner Terry Roland brought a motion forward to strip a $115,000 county grant meant for condom distribution through Planned Parenthood.

It remains to be seen how the new channel of federal funding will be divided up, or if organizations that did not receive a verbal agreement from the state are prioritized.

Many of the organizations affected by the state’s decision to forgo federal funding formed a statewide coalition in an effort to appeal to the CDC directly.

In a statement, the coalition expressed, “Immense gratitude to the coalition of leaders, agencies, and individuals in pursuing a solution, and want to show special thanks to the HIV and AIDS-impacted individuals who shared their personal stories as part of these efforts.”

Contributing: Corinne Kennedy, Commercial Appeal

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