Throughout most of the 2000s, state Ryan White HIV/AIDS Program (RWHAP) Part B programs — ADAPs — were forced to place financially eligible
Persons Living with HIV/AIDS (PLWHA) on waiting lists to receive financial assistance to afford medications to treat HIV. These waiting lists were largely the result of insufficient funding to keep up with the demand for ADAP services by new potential patients through the congressional appropriations process through which state ADAP programs are funded. Unlike entitlement programs such as
Medicaid, the state ADAP programs are funded as discretionary grant programs. This means that Congress chooses a portion of the RWHAP Part B appropriation for the ADAP base. The amount that each state receives is determined by the
Health Resources and Services Administration through the use of a funding formula that takes into account the number of PLWHA in the state or territory in the most recent calendar year. During the 2000s, states and territories across the United States were forced to develop waiting lists that ranged from as few as 1 person to as many as hundreds of people. Other states closed registration to new applicants or instituted state-level eligibility guidelines beyond those required by HRSA. PLWHA who were financially eligible to receive assistance from state ADAP programs found themselves unable to receive them, forcing delays in care and treatment. These treatment delays likely contributed to the 2006 deaths of at least three PLWHA who were on
South Carolina's ADAP waiting list, the announcement of which led to nationwide calls for the appropriation of emergency funds and increased overall appropriations to end waiting lists. By 2017, ADAP waiting lists were all but been eliminated as a result of reprogrammed funding from other parts of the RWHAP and separate Congressional emergency funding allocations between 2010 and 2013. ==2006 reauthorization==