Your Help is Needed to SAVE ADAP  (AIDS Drug Assistance Program)

   April 13, 2007
571 on ADAP Waiting Lists

As of March 2007, four states have reported waiting lists for their AIDS Drug Assistance Programs (ADAPs) totaling 571 HIV-positive people in need, according to the 2007 National ADAP Monitoring Project Report. The annual survey of United States ADAP programs, prepared by the Kaiser Family Foundation and the National Alliance of State and Territorial AIDS Directors (NASTAD), also points out that the number of people living with HIV/AIDS in the United States receiving antiretrovirals through these programs has more than tripled in the last decade.

ADAPs are federal- and state-funded programs that provide medications to treat HIV and AIDS-related complications to low-income, uninsured, or underinsured people living with HIV/AIDS. For the past 11 years, the National ADAP Monitoring Project has conducted a comprehensive survey of all state and territorial ADAPs and, in its annual reports, provided the latest available data on the status of these programs.

With close to 142,000 current enrollees, the report says, ADAPs reach approximately one-quarter of all people with HIV/AIDS in care. Approximately two-thirds of those served are people of color, more than half have incomes at or below the Federal Poverty Level (FPL) – the FPL was $9,800 annually for a family of one in 2006 – and almost three-quarters are uninsured.

As the nation's prescription drug safety nets for people living with HIV/AIDS, ADAPs help to secure access to life-saving treatment. However, the protection offered by these safety nets varies considerably across the country and, ultimately, what one gets depends on where one lives. For example, ADAP income eligibility in June 2006 ranged from 125% of the FPL in one state to 500% of the FPL or more in four states.

Formulary coverage – the specific medications for HIV and AIDS covered by these programs – varies significantly from state to state. In some states, only a few drugs are covered – including one state (South Dakota) that does not cover any protease inhibitors and several that do not cover Fuzeon® (enfuvirtide) – whereas other states provide extensive coverage to a wide variety of medications.

According to the report, this variation is the result of the way in which ADAPs, and the Ryan White Program overall, are structured. As discretionary grant programs, not entitlements, they are dependent on annual federal appropriations and funding from states and other sources where available – resources that are not necessarily tied to the number of people who need services and the cost of their care.

ADAPs must delicately balance available program capacity with client demand. To do so, ADAPs use the "levers" available to them, particularly through setting income and other eligibility criteria and determining the composition of their formularies. In some cases, the report concludes, this balancing act becomes one of difficult trade-offs between serving more people with less services and serving less people with more.

Waiting lists, while much fewer in number than in previous reports, remain a reality. Waiting lists reached their peak in mid-2004, but began to decline soon after, largely due to the introduction of the President's ADAP Initiative, time-limited funds to address waiting lists, and to increases in state funding; some ADAPs also report that the new Medicare Part D prescription drug benefit helped to alleviate their waiting lists. Still, in March 2007, four states reported waiting lists, totaling 571 people, the highest number of people on waiting lists in more than 12 months.

Another issue raised in the report is the latest reauthorization of the Ryan White program, particularly its new minimum ADAP formulary requirement. The National ADAP Monitoring Project points out that this is likely to offer both new opportunities and challenges to ADAPs and their clients. As of July 1, ADAPs will be required to cover at least one medication from each approved antiretroviral drug class. Currently there are four, but this provision will apply to any future classes of antiretrovirals. While this will certainly expand access to highly effective medications not previously available in some cases, it may also strain ADAP resources in others, which itself could result in access limitations to other components of the program.

These and other overarching trends and findings concerning ADAPs, along with comprehensive background information regarding these programs, can be found in the full 2007 report, posted by the Kaiser Family Foundation.

      written by Tim Horn

NOVEMBER 9, 2006

The South Carolina Health Department confirmed this week that three people with HIV/AIDS died while on the waiting list for the AIDS Drug Assistance Program (ADAP). Kathie Hiers of AIDS Alabama said, "It's like standing on a track watching the train coming at you, but you can't move." More than 300 people with HIV/AIDS are on the waiting list.

Congressman Maurice Hinchey, a New York Democrat, joined with the rest of the state's delegation six months ago in asking the House for $105 million in emergency ADAP funds, but the proposal was not acted upon. Additionally, under proposals supported by the White House, AIDS care funds would be cut to many states, including New York, with high caseloads.

Make Phone calls this Monday

On November 20, make three phone calls to government officials who can stop the deaths and end the ADAP waiting lists in SC and nationwide:

1. Call SC Health Commissioner Earl Hunter at 803-898-3432 and tell him to make an immediate request to the Budget and Control Board for $3 million in emergency state funding for ADAP.

2. Call SC Budget and Control Board Executive Director Frank Fusco at (803) 734-2320 and tell him the BCB must approve $3 million in emergency state funding for ADAP.

3. Call US President George Bush at 202-456-1414 and ask him to send an emergency message to Congress asking for $641.9 million in new funding for the Ryan White CARE Act to end the waiting lists for treatment and care across the US.

see actions and caravans organized by the South Carolina Campaign to End AIDS

 Let President Bush Know What HIV/AIDS Patients Really Need

      No waiting lists for AIDS drugs in our United States!

  We need $303 million in order to provide HIV+ Americans healthcare in this country.

           Bush Administration Abandons Americans Affected by HIV/AIDS

$303 Million AIDS Drug Assistance Program Increase Critical Almost 2,000 Americans living wiith HIV//AIDS on Explodiing Waiting Lists

For the last five years, President Bush and the Congress of the United States have ignored one of the largest public health crises in American History. Every year the number of newly infected Americans grows by 40,000 cases. The Center for Disease Control now estimates that there are now 1.185 million Americans living with HIV/AIDS, 70% of which need public assistance to be able to access their life saving drugs.

Yet, for the last five years, the AIDS Drug Assistance Program (ADAP) has not received the necessary increases in funding to keep pace with the growth of the AIDS pandemic. Without access to these life saving drugs, Americans living with HIV/AIDS have a future of declining health, increased infections and hospitalization, disability, and eventual death. In the richest nation in the world, this is an unacceptable future for our fellow Americans living with HIV/AIDS. Yet, with access to ADAP Americans living with HIV/AIDS can have long, productive lives.

We demand that President Bush stop abandoning us and provide the critical $303 million immediately to ADAP to end the “waiting lists.”


SAVE ADAP hosted on August 25, 2005, the Crawford SAVE ADAP Summit, a town hall meeting to discuss the current HIV/AIDS crisis in Crawford, Texas. If you would have any questions please contact Robert Reed at contact 314- 518 – 2430 or or Jeff Bloom at 202-352-7150 or

          download pdf flyer 1
          download pdf flyer 2


1) The CDC reported that there now are 1.185 million Americans living with HIV/AIDS, representing an increase of 235,000 newly infected Americans since 2002.

2) Today 55% of HIV infections are due to heterosexual transmissions.

3) The CDC estimates that there are 40,000 newly HIV infected Americans every year, but funding of HIV/AIDS programs in the US have been consistently under funded since FY 2001.

4) Nearly 70% of all Americans living with HIV/AIDS in the US rely on public healthcare or are uninsured. Funding decisions for the Ryan White Care Act, including ADAP, are vital to the health and well-being of hundreds of thousands of Americans living with HIV/AIDS.

5) The ADAP program saves lives, promotes health, and allows Americans living with HIV/AIDS to live productive lives with dignity. Both the cost in lives lost as well as increased medical expenses are much higher than the $303 million that can keep Americans living with HIV/AIDS healthy and productive.

Nine State ADAPs Have Waiting Lists; Eight States Anticipate New, Additional Access Restrictions, NASTAD says

August 11, 2005    Sixteen state AIDS Drug Assistance Programs either have implemented waiting lists or are considering other cost-containment measures, according to the latest ADAP Watch released on Wednesday by the National Alliance of State and Territorial AIDS Directors (ADAP Watch, 8/10). ADAPs are federal- and state-funded programs that provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals. In June 2004, President Bush announced $20 million in one-time funding outside of ADAP. The funding helped provide medications directly to HIV-positive people living in the 10 states that had waiting lists at that time (Kaiser Daily HIV/AIDS Report, 6/10). As of July 18, 1,922 HIV-positive individuals were on ADAP waiting lists in nine states, but 1,487 of those patients are covered under the additional funding. However, the funding is scheduled to expire in September 2005. The remaining 435 individuals on waiting lists from ADAPs are not covered under the president's ADAP initiative (NASTAD release, 8/10). The nine states that currently have waiting lists include: Alabama, Alaska, Arkansas, Idaho, Kentucky, Montana, Nebraska, North Carolina and West Virginia. Twelve states -- Alabama, Arkansas, Georgia, Indiana, Kansas, Louisiana, Missouri, New Hampshire, Oklahoma, South Dakota, Texas and Utah -- have implemented other cost-containment strategies. In addition, eight states -- Alaska, Georgia, Kansas, Louisiana, Missouri, New Hampshire, Oregon and Tennessee -- anticipate the need to implement new or additional cost-containment measures during the 2005 ADAP fiscal year, which ends March 31, 2006 (ADAP Watch, 8/10). "Now that states have been notified of the initiative's discontinuation, they are scrambling to identify viable strategies to ensure continuous access to treatment for these clients," NASTAD Executive Director Julie Scofield said, adding, "Without additional funding, states will not be able to incorporate these new patients into their ADAPs and hundreds of people may face losing their medications" (NASTAD release, 8/10).

AIDS Treatment Activists Coalition
One Person Can Help; Stop The ADAP Crisis

Write To President Bush and Ask Him To Save ADAP
August 8, 2005
SAVE ADAP is kicking off our August campaign by asking people around the country to write a letter to President Bush asking him to provide adequate funding for the AIDS Drug Assistance Program.
ADAP has been underfunded for the past several years, forcing many states to create waiting lists and other program restrictions. While experts have determined that a $303 million increase is needed in the Fiscal Year 2006 appropriations bill to alleviate the ADAP crisis, President Bush is only asking for a $10 million increase. So far, Congress is going along with that request and ADAP is likely headed for another year of crisis, with even more states unable to provide drugs to those who need them.
It is not too late! President Bush can tell leaders in Congress that he wants a higher increase for ADAP in the final appropriations bill.
That is why we are asking you to write a letter asking him to take leadership on this life and death issue. SAVE ADAP is collecting these letters and will both fax them to the White House and hand deliver to key members of the Bush Administration.
Over the past few years, your calls and emails have made a big difference. We have educated Congress and the Bush Administration about the ADAP crisis and it is one of the few health care programs that receives any increased funding. Now it’s time to take another step and tell President Bush that it’s not enough and that we are going to continue speaking out until everyone in the country has access to lifesaving drugs!
What you can do:
Please write a short letter to President Bush urging him to support a $303 million increase for ADAP. Below is a sample letter for you to use. Add a couple of sentences about how ADAP has helped you or people you care about, or simply why you want the federal government to give adequate funding to this program.
This letter can be from organizations and individuals. Once you’ve written your letter, ask others to do the same! Your family, friends, coworkers, neighbors – they don’t need to be familiar with ADAP, just share your belief that no one should be on a waiting list for drugs they need to stay alive and be healthy. If you work for an organization, encourage your clients to write a letter. You can collect them and send to us in a bunch.
Make sure you include your name and mailing address on the letter. Our goal is to have letters from all 50 states, District of Columbia, and the territories.
You can mail, fax, or email your letter to us:
        Ryan Clary
        c/o Project Inform
        205-13th Street, #2001
        San Francisco, CA  94103
        Fax:  (415) 558-0684    Email:
Sample letter:
The President
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500
Dear President Bush,
I am very concerned that Americans living with HIV/AIDS around the country are unable to get life-saving drugs from their state's AIDS Drug Assistance Program. Because of the financial crisis facing ADAP, many states have been forced to create waiting lists, close their program to new enrollees, and/or make other harmful changes.
Experts have determined that a $303 million increase for ADAP is badly needed for Fiscal Year 2006 to clear the waiting lists and ensure that people living with HIV/AIDS can gain access to the program. Congress is only proposing a very inadequate $10 million increase for ADAP for FY 06. This will guarantee that the ADAP crisis will worsen and that even more states will be unable to make sure that their citizens will receive the drugs they need.
We need your leadership on this life and death issue. Everyone living with HIV/AIDS should have access to the drugs that are vital to stay alive, healthy and productive. Please tell Congress that you strongly support a $ 303 million increase for the AIDS Drug Assistance Program for FY 06 in the final appropriations bill.
Thank you for your consideration. Only you can provide the leadership to help Congress do the right thing for Americans living with HIV/AIDS.
Sincerely,  ____________________

You can also reach your Representative by calling the Congressional switchboard toll-free at 1-800-839-5276. Ask to be connected to your Representative's office. You'll need to know who your Representative is in advance. If you don't know who represents you, go to

 Previous Senate "Dear Colleague" Letter:

In April 1994, four U.S. Senators sent out a very powerful bipartisan "Dear Colleague" letter in support of providing badly needed fiscal relief to the AIDS Drug Assistance Program (ADAP). The letter is co-authored by Senators Jeff Bingaman (D-NM), Richard Durbin (D-IL), Gordon Smith (R-OR), and Olympia Snowe (R-ME).

Not only does this letter ask for a $217 million increase for ADAP for the next fiscal year, but it also supports an immediate emergency supplemental increase of $122 million to help deal with the current ADAP crisis.

As of June 8th, 21 additional Senators have signed this letter (see list below).

Sign-ons are still being collected, as this letter could be used whenever an opportunity exists for an emergency supplemental appropriation. The more signatures on this letter (and the more bipartisan the list), the better chance that the Senate will consider emergency funding for ADAP.

Please take a minute to call your two U.S. Senators about this letter. If they have already signed on, thank them for their leadership. If they haven't signed, urge them to add their name. Be sure to talk about how ADAP affects you or people you care about. If there is an ADAP crisis in your state, let them know that you expect them to fight for adequate federal funding to help ensure that everyone has access to lifesaving treatment.

You can reach your U.S. Senators through the same toll-free number above.

Current Senate "SAVE ADAP" letter sign-ons (as of June 8th):


Jeff Bingaman (D-NM)
Richard Durbin (D-IL)
Gordon Smith (R-OR)
Olympia Snowe (R-ME)


Daniel Akaka (D-HI)
Barbara Boxer (D-CA)
Maria Cantwell (D-WA)
Jon Corzine (D-NJ)
Tom Daschle (D-SD)
Mark Dayton (D-MN)
James Jeffords (I-VT)
Tim Johnson (D-SD)
Ted Kennedy (D-MA)
John Kerry (D-MA)
Frank Lautenberg (D-NJ)
Carl Levin (D-MI)
Joseph Lieberman (D-CT)
Blanche Lincoln (D-AR)
Barbara Mikulski (D-MD)
Patty Murray (D-WA)
Mark Pryor (D-AR)
Paul Sarbanes (D-MD)
Charles Schumer (D-NY)
Debbie Stabenow (D-MI)
Ron Wyden (D-OR)

Thank you for taking the time to make your voice heard on this important issue!

The Save ADAP Committee is a Working Group of the AIDS Treatment Activists Coalition (ATAC), a national coalition of AIDS treatment activists and policy advocates. Working in conjunction with ADAP clients and service providers on the grassroots level, Save ADAP aims to ensure adequate funding for the AIDS Drug Assistance Program. For more information go to:

To receive SAVE ADAP Alerts via email, send an email to with "subscribe" in the subject field.

June 30, 2004

Kaiser Daily HIV/AIDS Report Summarizes News on State AIDS Drug Assistance Programs

President Bush in Philadelphia last week announced that the administration would make available $20 million for AIDS Drug Assistance Programs in states with waiting lists for HIV-positive people to receive antiretroviral drugs. ADAPs -- which are supported with both state and federal Ryan White CARE Act funds -- provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals (Kaiser Daily HIV/AIDS Report, 6/24). The number of people on waiting lists for enrollment in ADAPs has increased nationwide from 1,263 in April to 1,629 in June, according to a report released earlier this month by the National Alliance of State and Territorial AIDS Directors. Alabama, Alaska, Arkansas, Colorado, Idaho, Iowa, Kentucky, Montana, North Carolina, South Dakota and West Virginia have waiting lists and/or access restrictions. In addition, Alabama, Arkansas, Colorado, Indiana, Oklahoma, South Dakota, Utah and Washington have implemented other cost-containment strategies since April. According to NASTAD, Massachusetts, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, Oregon, South Carolina and Texas are anticipating new or additional restrictions during fiscal year 2004, which ends March 31, 2005 (Kaiser Daily HIV/AIDS Report, 6/8).

The new funding announced by Bush last week could help the 353 people on Alabama's ADAP waiting list, the Birmingham News reports. At a cost of $10,000 per patient annually, Alabama should receive about $3.52 million, according to the News. However, Dr. Charles Woernle, assistant state health officer for disease control and prevention, said he is waiting for "official documentation" ensuring that the state will receive sufficient funds to cover all patients on the waiting list. Although HIV-positive people on ADAP waiting lists have been receiving free drugs from pharmaceutical companies, the process to secure the drugs is "tedious and complicated," Woernle said, adding that it is "more efficient [to] have a direct pipeline to get folks the drugs they need." Jim Raper, a nurse practitioner and the administrative director at the University of Alabama--Birmingham's 1917 Clinic, said that moving people off the waiting list and out of pharmaceutical company programs will allow the clinic's social workers to find housing and provide counseling and other services for HIV-positive people. However, the ADAP program is not necessarily "in the clear," according to the News. "It begs the question, how long will that money be forthcoming and what happens to the next person who comes up after we liquidate the waiting list?" Woernle asked (Abrams, Birmingham News, 6/28).

Although Arkansas needs $5.1 million annually to care for its 460 ADAP beneficiaries, the program receives only $3.1 million each year and is not one of the states set to receive funding under Bush's plan, according to Lola Thrower of Arkansas' ADAP. Thrower was one of several doctors and public health officials who testified on Monday before a state Joint Minority Health Subcommittee. Michelle Smith of the Jefferson Comprehensive Care System said during her testimony that the Ryan White CARE Act funds that her organization receives are inadequate to meet the group's growing needs. Doctors and public health officials at the hearing said that minorities in the state were receiving insufficient education about the risks of certain diseases, including HIV/AIDS. Although minorities comprise only 19% of Arkansas' population, they account for 43% of the state's AIDS cases. However, the committee said that the possibility of increased funding was unlikely, according to the Associated Press (Hammer, Associated Press, 6/29).

Iowa is one of the 10 states set to benefit from the federal money, which will help the Iowa's ADAP treat the 16 people on its waiting list, the Des Moines Register reports. However, it does not address the program's long-term funding problems, Iowa ADAP manager Holly Hanson said, adding that the funding is "just a Band-Aid." In addition, the requirements tied to the new funding will create "a lot of administrative work," Hanson said. None of the funding will go directly to the state ADAP. As a result, Iowa will have to gather information on the drug regimens of the 16 people on the waiting list and report them to the federal agency that oversees the state ADAP. Because the state does not keep individual drug records and because of frequent drug changes, Hanson said that the process will be "complicated," according to the Register. In addition, only the 16 people who were on the waiting list at the time of the announcement will be eligible for the funding, meaning that anyone who has applied for ADAP coverage since then will be placed on a waiting list, Hanson said, adding that she receives about 12 new applications each month, the Register reports (Sagario, Des Moines Register, 6/28).

The number of people on waiting lists for ADAP by state.

NASTAD National Alliance of State and Territorial AIDS Directors

MEDIA ALERT For further information, contact: Murray Penner (202) 434-8090

November 3, 2003


The National Alliance of State and Territorial AIDS Directors (NASTAD) has released its latest “ADAP Watch,” a listing of AIDS Drug Assistance Programs (ADAPs) that have implemented or anticipate implementing restrictions.

ADAPs provide life-saving HIV treatments to low income, uninsured, and underinsured individuals living with HIV/AIDS in all 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, three U.S. Pacific Territories (Guam, the Commonwealth of the Northern Mariana Islands, and America Samoa), and one Associated Jurisdiction (the Republic of the Marshall Islands). Federal funding for ADAPs in FY2002 and FY2003 has been insufficient to meet the needs of those eligible and has led to a fiscal crisis for many state ADAP programs. Currently, 679 people are on waiting lists awaiting enrollment into ADAP programs.

AIDS treatment policy experts have determined that a $214 million increase is needed for ADAPs in FY2004 in order to alleviate restrictions and the ADAP crisis. This figure takes into account the current budget shortfall in the program, the needs of those on waiting lists, and the addition of a new class of fusion inhibitors as well as hepatitis C treatments. The House and Senate have passed spending bills that include an increase for ADAP of $38.9 million and $24.7 million respectively. Either of these funding amounts will fall far short of meeting the demand of those in need of life-sustaining drugs. NASTAD strongly encourages Congress to increase funding for these vital programs.

NASTAD reports the following 16 state ADAPs with waiting lists and/or access restrictions as of November 2003:

Alabama: capped enrollment, 141 on waiting list
Arkansas: capped enrollment
Colorado: capped enrollment and reduced formulary, 130 on waiting list
Idaho: capped enrollment, monthly expenditure cap
Indiana: capped enrollment, 47 on waiting list
Kentucky: capped enrollment, 140 on waiting list
Montana: capped enrollment, 1 on waiting list
Nebraska: capped enrollment, 30 on waiting list
New Mexico: capped enrollment
North Carolina: capped enrollment, 96 on waiting list
Oklahoma: reduced formulary and annual expenditure cap
Oregon: reduced formulary, lowered financial eligibility, imposed cost-sharing, 24 on waiting list
South Dakota: capped enrollment, 49 on waiting list
Washington: lowered financial eligibility criteria, reduced formulary, imposed cost-sharing
West Virginia: capped enrollment, 21 on waiting list
Wyoming: reduced formulary, lowered financial eligibility

NASTAD further reports the following five (5) ADAPs as anticipating new or additional restrictions in FY2003:

ADAPs anticipating new/additional restrictions in FY2003

New Hampshire

In Alabama, 141 people are on a waiting list, program director Jane Cheeks says. The funding is so dire that 100 people now receiving medications would have to be removed before a single person on the waiting list could get treatment. Even worse, Cheeks said by April she has to dump 41 people now receiving drugs. A recent state proposition would have allowed a tax to cover, among other things, AIDS care. But it was voted down.

"It's just a bad situation that's going to get worse," she said.

In North Carolina, a hundred people are on the ADAP waiting list. Colorado has 130; Indiana, 47; Nebraska, 30; Oregon, 24; South Dakota, 49; Montana, 1.

Wait Lists for AIDS Drugs Grow in 10 States
AIDS patients in 10 states can't get life-saving drugs

by Laurie Garrett, NY NEWSDAY  November 26, 2003

Three People Just Died on ADAP Waiting Lists!
August 28, 2003 THE CHARLESTON GAZETTE – Charleston, West Virginia  

West Virginia's AIDS Drug Assistance Program stopped taking new patients almost seven months ago. Since then, three patients have died waiting to get the free HIV/AIDS drugs provided by the federally funded ADAP, a drug program for low-income patients who do not qualify for Medicaid or other drug programs. Another 14 patients are still waiting to be enrolled. "People are now starting to die while they're on the waiting list," said Dr. Faisal Khan, director of West Virginia's HIV/AIDS/STD program. "It is a crisis that will continue." read more

Five People Died Waiting This Year
Kentucky ADAP Crisis on Local NBC News

September 24th, 2003  Local NBC News   LOUISVILLE, KENTUCKY

Right now, 169 people in Kentucky are on the ADAP waiting list. By December, that number is expected to grow to 200. Already this year, five people have died waiting for medication. read more

  Past SAVE ADAP Alerts  

Final Decisions Being Made on ADAP Funding
Please call your Representative/Senators one last time to save ADAP!

September 29, 2003

Thank you again to everyone who has helped try to save ADAP this year by calling, writing, and meeting with your Members of Congress about this important issue! As you know from our last update, the Senate voted against the Schumer amendment, which would have provided a substantial increase for ADAP and other Ryan White CARE Act programs.   
[see below]

We are now at the end of the appropriations process for Fiscal Year 2004, and there is a final opportunity to encourage Congress to pass the highest possible increase for ADAP. Because the House of Representatives and the Senate proposed different increases for ADAP, a joint House/Senate “conference committee” will come together to work out differences.

The amounts passed by the Senate and House are extremely inadequate. The House has proposed a $39 million increase, while the Senate voted for a $25 million increase. Both amounts are far below the $215 million increase identified by AIDS treatment experts as needed to alleviate the current ADAP crisis.

Once again, Senator Charles Schumer (D-NY) is taking the lead on fighting for people with HIV by authoring a “Dear Colleague” to the conference committee. The letter asks for increases for the entire Ryan White CARE Act, including an additional $214.8 million increase for ADAP, at the levels included in his amendment.

This letter provides another chance for Senators to do the right thing and fight for funding needed for vital care and treatment programs for people with HIV/AIDS.

In addition, House Representatives need to be asked to convey their support for adequate ADAP funding to the conference committee members. Key members of that committee need to hear from people around the country that their leadership is needed to alleviate the treatment access crisis. Please take a few minutes this week to make some important phone calls.

What you can do:

There are several phone calls you can make this week to make a difference. A toll-free number is included below, so there is no cost to you. Please make as many of these calls as possible!

1. Call your two U.S. Senators’ D.C. office. Ask to speak to the legislative aide who handles HIV/AIDS and healthcare issues. If your Senator voted in favor of the Schumer Amendment (see list below), thank him/her for his vote and ask that the Senator sign Senator Schumer’s “Dear Colleague” letter.

If your Senator voted against the Schumer amendment, express your disappointment in that vote and let them know that you expect them to sign Senator Schumer’s letter. If you are in one of the ADAP crisis states, and your Senator voted no, ask how he/she can justify turning their back on their constituents who are facing barriers to treatment access.

2. Call your U.S. Representative’s D.C. office and ask to speak to the legislative aide who handles HIV/AIDS and healthcare issues. Identify yourself as a constituent and let them know that you urge your Representative to ask the Labor-HHS appropriations conference committee to support a $215 million increase for the AIDS Drug Assistance Program, the amount needed to alleviate the current fiscal crisis.

3. Call the following key members of the conference committee (toll-free number):

Senator Arlen Specter (R-PA)
Chair of Senate Labor-HHS Appropriations Subcommittee

Senator Tom Harkin (D-IA)
Ranking Member, Senate Labor HHS Appropriations Subcommittee

Representative Ralph Regula (R-OH)
Chair of House Labor-HHS Appropriations Subcommittee

Representative David Obey (D-WI)
Ranking Member, House Labor-HHS Appropriations Subcommittee

Unless you are a constituent, do not ask for a legislative aide, but leave
the following message with the person who answers the phone:

“I am calling to urge Senator/Representative____________ to support adequate
funding for HIV/AIDS care and treatment programs, including a $215 million increase for
the AIDS Drug Assistance Program.
Senator/Representative_______________ is making decisions in conference committee
that affect people with HIV across the country and should support the funding increase
needed to ensure that all Americans have access to lifesaving treatment.”

Call Washington DC today toll-free: (1) ask your House Member to sign on to the Shays/Nadler/Crowley letter on HOPWA and the Bono letter on Ryan White Title III and (2) ask your Senator to sign on to the Schumer "Dear Colleague" letter to increase all the Ryan White Titles.

Call the Capitol switchboard toll-free at 800-648-3516 to be transferred to your House Member or Senator. To find out who represents you in the House or Senate, go online at or call 1-888-VOTE-SMART (1-888-868-3762).

1. Housing Opportunities for Persons with AIDS (HOPWA): TEN MILLION DOLLARS AT STAKE

Homeless people with AIDS get sicker faster, die more often, and incur preventable costs for expensive medical treatment that could be saved by investments in supportive housing. The House budget included $10 million more for HOPWA than the Senate budget, and it’s important to keep that $10 million in the final budget: every HOPWA dollar saves lives and saves money.

ASK YOUR REPRESENTATIVE IN THE HOUSE: "Please sign on to the letter on HOPWA circulated by Reps. Shays, Nadler & Crowley today (contact David Greengrass in Rep. Nadler’s office)."

2. Ryan White Title III (Community Health Centers): 4.4 MILLION DOLLARS AT STAKE

This year’s House budget included the first cut in Ryan White AIDS funding in the history of the epidemic: a $4.4 million cut to Title III Community Health Center funding. In the face of increasing HIV infections and increasing need, any cut of funding is just plain deadly – we can’t let it stand.

ASK YOUR REPRESENTATIVE IN THE HOUSE: "Please sign on to the letter on Title III circulated by Rep. Mary Bono today (contact Katherine Martin in Rep. Bono’s office)."


This year’s House budget included a $39 million add to ADAP funding, and the Senate added $25 million. President Bush had proposed a $100 million increase for ADAP this year, and we are hope that conferees will consider that higher figure. Nationwide, fifteen state ADAP programs have waiting lists or restrictions on medications and services. In West Virginia, two people recently died of AIDS while on the waiting list for ADAP. Increased funding for ADAP is literally a life-and death issue.

ASK YOUR SENATORS: "Please sign on to the letter on Ryan White & ADAP circulated by Senator Schumer today. (Contact Heather Langdon in Sen. Schumer’s office)."

On global AIDS issues, there is a chance for last-minute amendments or other attempts to increase funding, but the conferees don’t have dollar
differences – they do have legislative language differences that could impact the future of the Bush Administration’s proposed initiative to fight AIDS in Africa and the Caribbean. We’ll get you more as the news gets in to us.

You can call your Representative and Senators toll-free by calling the Capitol Switchboard at 1-800-648-3516.

You’ll need to know their names and ask to be transferred. Don’t know who your Senators/Representatives are? Go to
Contacting your Congress Member

You can also find phone numbers and other contact information on Project Inform's legislative directory

September 10, 2003:


New York Senator Charles Schumer’s amendment to increase funding for domestic AIDS programs failed today by a vote of 53-44. Several Democrats voted against the bill, and presidential candidates Joe Lieberman and John Edwards didn’t show up to vote for it, despite being present in Washington for a vote on overtime pay important to labor unions.

Senate Republicans have sought flat funding for most domestic AIDS programs, but Schumer has fought back with an amendment that would increase funding for all titles of the Ryan White CARE Act, including $280 million for the hard-pressed ADAP program, which in many states provides the bulk of HIV care for impoverished and poor Americans living with HIV.

An amendment to increase funding for global AIDS programs introduced by Illinois Senator Dick Durbin also failed today, by a vote of 51-43. There is still a possibility that the Senate GOP leadership might take the FY 04 Appropriations bill off the floor and substitute an omnibus budget bill, which could provide an opportunity for adding more AIDS funding in conference. The differences between final funding levels approved by both the House and Senate will be resolved in a conference committee later this month. For more information on federal appropriations advocacy, call Michael Kink at 518-449-4207 or email The final vote on the Schumer Amendment is included below. 


YEAS -- 44
Akaka (D-HI)
Baucus (D-MT)
Bayh (D-IN)
Biden (D-DE)
Bingaman (D-NM)
Boxer (D-CA)
Breaux (D-LA)
Byrd (D-WV)
Cantwell (D-WA)
Clinton (D-NY)
Corzine (D-NJ)
Daschle (D-SD)
Dayton (D-MN)
DeWine (R-OH)
Dodd (D-CT)
Durbin (D-IL)
Feingold (D-WI)
Feinstein (D-CA)
Graham (D-FL)
Harkin (D-IA)
Hollings (D-SC)
Inouye (D-HI)
Jeffords (I-VT)
Johnson (D-SD)
Kennedy (D-MA)
Kerry (D-MA)
Kohl (D-WI)
Landrieu (D-LA)
Lautenberg (D-NJ)
Leahy (D-VT)
Levin (D-MI)
Lincoln (D-AR)
Mikulski (D-MD)
Murray (D-WA)
Nelson (D-FL)
Nelson (D-NE)
Pryor (D-AR)
Reed (D-RI)
Reid (D-NV)
Rockefeller (D-WV)
Sarbanes (D-MD)
Schumer (D-NY)
Stabenow (D-MI)
Wyden (D-OR)

NAYs ---53
Alexander (R-TN)
Allard (R-CO)
Allen (R-VA)
Bennett (R-UT)
Bond (R-MO)
Brownback (R-KS)
Bunning (R-KY)
Burns (R-MT)
Campbell (R-CO)
Carper (D-DE)
Chafee (R-RI)
Chambliss (R-GA)
Cochran (R-MS)
Coleman (R-MN)
Collins (R-ME)
Conrad (D-ND)
Cornyn (R-TX)
Craig (R-ID)
Crapo (R-ID)
Dole (R-NC)
Domenici (R-NM)
Dorgan (D-ND)
Ensign (R-NV)
Enzi (R-WY)
Fitzgerald (R-IL)
Frist (R-TN)
Graham (R-SC)
Grassley (R-IA)
Gregg (R-NH)
Hagel (R-NE)
Hatch (R-UT)
Hutchison (R-TX)
Inhofe (R-OK)
Kyl (R-AZ)
Lott (R-MS)
Lugar (R-IN)
McCain (R-AZ)
McConnell (R-KY)
Miller (D-GA)
Murkowski (R-AK)
Nickles (R-OK)
Roberts (R-KS)
Santorum (R-PA)
Sessions (R-AL)
Shelby (R-AL)
Snowe (R-ME)
Specter (R-PA)  < Delivered Funeral Wreath
Stevens (R-AK)
Sununu (R-NH)
Talent (R-MO)
Thomas (R-WY)
Voinovich (R-OH)
Warner (R-VA)

Not Voting - 3

Edwards (D-NC)
Lieberman (D-CT)
Smith (R-OR)

Activists Deliver Funeral Wreath





ADAP provides treatment for people with HIV/AIDS who otherwise would not be able to afford it. Currently, 15 state ADAPs have been forced to implement limits to treatment access, including waiting lists. It is patently unacceptable to deny life-saving medications to people who need them. Anti-HIV drugs have been successful in dropping the death rate from AIDS in the United States by over two-thirds since 1996.

Please fully fund this compassionate and desperately needed program. I also urge you to support the highest possible funding amounts for all HIV/AIDS domestic and international programs.


NAME: ___________________________ ADDRESS: _____________________________

SIGNATURE: _____________________ CITY, STATE, ZIP: ________________________

Contacting your Congress Member

You can also find phone numbers and other contact information on Project Inform's legislative directory

download White Paper

The History and Status of the ADAP Funding Crisis
August 2003  (pdf)

August 4, 2003
Save ADAP Action Alert - Call the White House


Last week, 180 community-based organizations from 29 states sent a letter to President Bush asking that he provide $283 million in new federal funding for AIDS Drug Assistance Programs in Fiscal Year 2004, as well as the highest level of funding for all Titles of the Ryan White CARE Act. (A copy of the letter can be found at

For the past four years, ADAP has been inadequately funded to meet the increasing demand. The funding levels being proposed this year are particularly shocking. To date, Congress has voted to appropriate only 10% to 15% of the amount needed. By the end of 2004, over 20,000 newly diagnosed HIV + Americans will not be able to receive life-saving medications from ADAP.

The expected widespread Program closures and access restrictions have already started. Nearly 600 people are currently on ADAP waiting lists across the country. Twelve states have capped enrollment (Alabama, Alaska, Arkansas, Colorado, Idaho, Kentucky, Nebraska, North Carolina, Oregon, South Dakota and West Virginia). Three states (New York, Washington and Oklahoma) have restricted access using other means (lowering financial eligibility caps, reducing formularies) and at least six additional states (including Texas and California) have reported that they anticipate implementing substantial new restrictions.

Please take a moment now to urge President Bush to fully fund ADAP by calling the White House

Take Action!

Anytime this month, August, Call the White House comment line (202) 456-1111 and follow the prompts to reach a real person.

Sample Message:

"My name is _____ and I'm calling from (city, state). I am calling to urge
President Bush to include a request for a $283 million increase for the AIDS
Drug Assistance Program (ADAP) in his Statement of Administration's Principles
regarding the Labor, Health and Human Services and Education appropriations
bill. I also urge that the Administration support the highest possible funding
for all Titles of the Ryan White CARE Act."

Please also include a personal message stating how important ADAP is to you and your love ones.

Thanks for your help to save ADAP!

What are ADAPs?

AIDS Drug Assistance Programs (ADAPs), funded primarily through the Ryan White CARE Act, provide HIV/AIDS prescription drugs to uninsured and underinsured individuals living with HIV/AIDS in the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam and other U.S. Territories.

ADAP covers patients who are primarily poor (81% earn less than $18,000 a year), minority (33% African American, 25% Hispanic) and without insurance covering prescription drugs. ADAP currently serves approximately 90,000 clients per month.

The Save ADAP Committee is a Working Group of the AIDS Treatment Activist Coalition (ATAC), a national coalition of AIDS treatment activists and policy advocates. Working in conjunction with ADAP clients and service providers on the grassroots level, Save ADAP aims to ensure adequate funding for the AIDS Drug Assistance Program.


Dear Colleagues,

On behalf of the SAVE ADAP Committee, thank you again for signing the Letter to President Bush urging him to include a $283 million increase for the AIDS Drug Assistance Program in his Statement of Administration Principles, along with the highest possible funding for all Titles of the Ryan White CARE Act.

We have received over 180 organizational sign-ons to this letter, demonstrating strong and broad support for adequate funding for these crucial programs.

Today, we faxed and mailed the final letter to President Bush. I am enclosing a copy of the Letter as an attached Word document to download.

We are hoping that you will consider faxing a copy of the letter to the President as well, along with a cover letter explaining your own organizational position on ADAP/CARE Act funding and perhaps that personalizes the issue by talking about how this funding affects you, your clients, people you love and care about. We feel that this will help ensure that the message is heard loud and clear by the White House.

Letters should be faxed to 202-456-2461

If you do participate in this action, please let me know.

Next week, we will be sending an Alert asking people to call the White House and follow up on the message contained in our sign-on letter. I'll make sure you get that Alert (unless you don't want to, just email me if you don't).

Thank you again for your support and efforts! Hopefully, together we will make a difference!

download final letter:  SAVEADAP_Bush_final.doc

Ryan Clary (on behalf of SAVE ADAP)
Senior Policy Advocate, Project Inform
205-13th Street, #2001
San Francisco, CA 94103
(415) 558-8669 x224
(415) 558-0684 fax

For more information, please contact one of the following SAVE ADAP members:

Bill Arnold (D.C.)
Title II Community AIDS National Network
(202) 588-1775,
Mark Baker (Massachusetts)
AIDS Support Group of Cape Cod
(508) 487-9445 ext. 47 or
Lei Chou (New York)
AIDS Treatment Data Network
James Carr (Indiana)
Ryan Clary (California)
Project Inform
(415) 558-8669 x224,
Lynda Dee (Maryland)
AIDS Action Baltimore
(410) 837-2437,
Amanda Diers (Florida)
Florida AIDS Action
(813) 974-2838,
Pat Donahue (Rhode Island)
Mark Garrett (Washington)
Spokane AIDS Network
(509) 455-8993 x221,
Sue Gibson (Texas)
Kathie Hiers (Alabama)
AIDS Alabama
(205) 324-9822 x331,
Patrick Lee (North Carolina)
North Carolina Council for Positive Living
(336) 586-0062,
Jim Musslewhite (Washington)
(360) 570-8380,
David Munar (Illinois)
AIDS Foundation of Chicago
(312) 922-2322,
Robert O'Brien (Pennsylvania)
(215) 803-5181
Murray Penner (D.C.)
National Alliance of State and Territorial AIDS Directors (NASTAD)
(202) 434-8099,
Fred Schaich (Oregon)
(503) 736-0194 FAX (503)736-9908
Jerry Spillman (California)
Brian Varner (Tennessee)
Tennessee AIDS Support Services, Inc.
(865) 525-7766,

Read more ADAP reports and articles

National AIDS Drug Assistance Program State Listings Index   [off-site] 

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