ADAP Shortfall Relief - Washington ADAP seeks $7 million in Emergency Relief Funds (ERF) to address rising treatment needs and prevent significant cost containment strategies that will reduce available services to people living with HIV enrolled in ADAP. The Washington Office of Infectious Disease which houses the Ryan White funds and programs for Part B and ADAP conducts a 5-year fiscal projection process for all fund sources and program activities including Ryan White and pharmaceutical rebates. Projections indicate that at our current spending, the program will need to implement cost cutting measures system wide by July 2027 in order to remain within the limits of the revenue sources projected at that time. The current most pressing environmental conditions impacting ADAP resources are Increased client enrollment as a result of the following factors: • HIV incidence rate growth, • Washington State population growth, including in state migration, • Strong Data 2 Care efforts and case investigation, • Higher number of individuals enrolled without insurance due to Medicaid unwinding, • Rising medication costs and intervention innovations, • Healthy aging for those living with HIV for a long time. The funding will cover full-cost medications for uninsured clients. The requested funds would maintain service continuity for current ADAP clients, prioritizing uninsured clients and ensure uninterrupted access to essential HIV treatment and improved health outcomes statewide. Washington State, with a population of 7.5 million, is concentrated in Western Washington and includes racial demographics of White (69%), Hispanic/Latinx (13%), Asian (8%), and Black (4%). Approximately 94% of the population is medically insured. Roughly 15,000 people live with HIV in Washington, with 400 new cases each year. HIV primarily impacts cisgender men, especially men who have sex with men (MSM), who represent 79% of new cases. Rates of new diagnoses have increased since 2016, especially among those aged 25-34, Black, and Hispanic/Latinx populations. Washington ADAP, under the Early Intervention Program (EIP), provides medications and insurance assistance, currently supporting 5,276 clients. The program can document a 37% increase from 2018 and a 26% increase since 2021. To prevent significant cost containment due to a projected fiscal shortfall, Washington ADAP requests $7 million in Emergency Relief Funds. ERF funds will ensure uninterrupted medication access for about 650 uninsured clients, extending service stability for Washington residents living with HIV.