Since 1996, the National RWHAP Part B ADAP Monitoring Project has surveyed all jurisdictions receiving federal ADAP earmark funding through the RWHAP. In FY2021, 58 jurisdictions received ADAP earmark funding and were surveyed; 47 provided data. Alabama, American Samoa, Federated States of Micronesia, Guam, Marshall Islands, Maryland, Mississippi, Northern Mariana Islands, Republic of Palau, US Virgin Islands, Virginia, and West Virginia did not provide data. After the survey is distributed, NASTAD conducts extensive follow-up to ensure completion by as many RWHAP Part B programs as possible.

This release of the Annual Report updates prior findings with data from fiscal year 2021 and calendar year 2021. All data reflect the status of ADAPs as reported by survey respondents. It is important to note that some program information may have changed between data collection and the Annual Report’s release. Due to differences in data collection and availability across ADAPs, some are not able to respond to all survey questions. Where trend data are presented, only states that provided data in the years being compared are included.

Data exceptions specific to a particular jurisdiction are provided in the notes section on relevant charts and tables.


NASTAD thanks state and territorial ADAP coordinators and their staff for their time and effort in completing the National RWHAP Part B ADAP Monitoring Survey, particularly against the backdrop of COVID-19- and Mpox-related strains on program staff. The National RWHAP Part B ADAP Monitoring Project is one component of NASTAD’s Health Care Access portfolio, which provides ongoing training and technical assistance to all state and territorial RWHAP Part B programs and ADAPs. The Project also serves as a resource center, providing timely information on the status of ADAPs to national coalitions and organizations, policy makers, industry members, and state and federal government agencies. NASTAD received support for the National RWHAP Part B ADAP Monitoring Project in 2022 from Gilead Sciences, Janssen Therapeutics, and ViiV Healthcare; the Project is also supporting with annual NASTAD membership dues. NASTAD also receives funding to provide technical assistance to ADAPs through a Training and Technical Assistance Cooperative Agreement with the Health Resources and Services Administration (HRSA).

Tim Horn is the primary author of this report, with Katie Herting providing vital data management and table/chart creation. Crucial input into the report data elements and survey design was provided by Kate Mcmanus and Andrew Strumpf of the University of Virginia, Amy Killelea of Killelea Consulting, and Auntré Hamp and Dori Molozanov of NASTAD. Important reviews and edits were provided by Stephen Lee and Auntré Hamp.

Dr. Stephen Lee, Executive Director

Elizabeth Crutsinger-Perry, Washington, Chair