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Local HIV service provider warns Medicaid cuts could disrupt PrEP and testing services in Prince George's County
Summary
Us Helping Us and local clinicians told the Board of Health that Prince George's County has service gaps, low PrEP uptake and limited local funding for HIV/STI prevention; presenters urged local funding, workforce development and public–private partnerships to sustain prevention and care if federal funding falls.
A community-based HIV service organization told the Prince George's County Board of Health on June 17 that cuts to Medicaid and federal public-health grants could worsen already large local gaps in testing, treatment and prevention services.
Dr. DeMarco Hickson, director of Us Helping Us, described the group's four-decade history of HIV outreach and presented county-level surveillance data showing that roughly 9,000 people in the county are living with HIV and that more than a quarter of those diagnosed are not retained in care. "Of the roughly 9,000 individuals who are living with HIV, 8,234 have been diagnosed," Hickson said; he also stated there are about 824 people who may be living with HIV but are undiagnosed.
Why it matters: Hickson and other presenters drew a link between limited local infrastructure and worse outcomes: countywide the presenter said there are approximately 66 hospital beds per 100,000 residents, one of the lowest reported rates, producing "service deserts" in the southern county and longer travel times to care. Hickson said low PrEP uptake is driven by limited provider availability, stigma and coverage gaps; he reported that of the county residents on PrEP served by Us Helping Us, all 49 receive services at the organization's Washington, D.C., office.
Recommendations and local funding proposals: Hickson urged the county to invest locally in HIV prevention and workforce development. He proposed community-led solutions and suggested a possible 1% local tax to create sustainable funding for HIV and STI prevention programs. He also urged stronger public–private partnerships and asked county leaders to prioritize maintaining Medicaid coverage for PrEP and HIV treatment because, he said, those services are currently covered by Medicaid and would be jeopardized by cuts.
Other community testimony: Daffodil Baez, president of Adventist Healthcare Fort Washington Medical Center, described hospitals' financial strain from reimbursement reductions and highlighted bed shortages in the county. Dr. Ogo Kwame of Career Haven urged leveraging providers and businesses to bridge service gaps.
Board follow-up: Council members asked about PrEP access, payment mechanisms and age breakdowns for new diagnoses. Hickson said local health-department funding to community providers is limited (he cited a combined local award of about $250,000 across several providers) and that many PrEP patients seek care outside the county for confidentiality or access reasons. The county health department representative told the board that no federal source currently pays directly for PrEP in Maryland and that local jurisdictions that offer free PrEP do so from locally allocated budget dollars.
