Methodology

Since 2016, NASTAD’s National RWHAP Part B and ADAP Monitoring Project has surveyed all jurisdictions receiving federal RWHAP Part B and ADAP funding through the RWHAP.  From 1996 to 2015, the National ADAP Monitoring Project surveyed all jurisdictions receiving federal ADAP earmark funding through the RWHAP. In FY2020, 59 jurisdictions received federal RWHAP Part B base funding and were surveyed; 46 responded. Alabama, American Samoa, Federated States of Micronesia, Indiana, Marshall Islands, Mississippi, Nevada, Northern Mariana Islands, and Republic of Palau did not respond. This release of the Annual Report updates prior findings with data from calendar years 2019 and 2020 and RWHAP Part B programs’ fiscal year 2020.

This year’s survey was developed and implemented through a contractual partnership with the University of Virginia (UVA). To both maximize data points spanning two calendar years and to minimize reporting requirements on Part B and ADAP staff, particularly in the context of COVID-19-related strains on health department program capacity, a number of program utilization and expenditure sections were eliminated from the 2021 survey:

  • RWHAP Part B core medical and support services utilization and expenditure reporting
  • Primary payer cost recovery
  • Medicare-specific questions
  • ADAP NDC-level expenditure data

After the survey was distributed, UVA and NASTAD conducted extensive follow-up to ensure accurate completion by as many RWHAP Part B programs and ADAPs as possible.

All data reflect the status of RWHAP Part B programs and 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 RWHAP Part B programs and ADAPs, some are not able to respond to all survey questions. Additionally, some Part B programs and ADAPs were unable to provide responses to some CY 2020 questions due to the unavailability of necessary data. 

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

Acknowledgements

NASTAD thanks state and territorial RWHAP Part B, ADAP, and HIV program managers and staff for their time and effort in completing the National RWHAP Part B and ADAP Monitoring Survey, particularly against the backdrop of COVID-19-related strains on program staff. The National RWHAP Part B and ADAP Monitoring Project is one component of NASTAD’s National RWHAP Part B and ADAP Monitoring and Technical Assistance Program which provides ongoing technical assistance to all state and territorial RWHAP Part B programs and ADAPs. The program also serves as a resource center, providing timely information on the status of RWHAP Part B programs, including 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 and ADAP Monitoring and Technical Assistance Program in 2021 from AbbVie, Gilead Sciences, Janssen Therapeutics, and ViiV Healthcare. 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; Kathleen A. McManus, MD MSCR; and Amber Steen are the primary authors of this document. The University of Virginia’s Center for Survey Research (CSR) conducted the primary data analysis. Important reviews and edits were provided by Stephen Lee, Auntré Hamp, and Andrew Strumpf.

Dr. Stephen Lee, Executive Director

Elizabeth Crutsinger-Perry, Washington, Chair

November 2021